TABLE ROCK PHYSICAL THERAPY (NPI# 1134639248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134639248 |
| Entity Type | Organization |
| Organization Name | TABLE ROCK PHYSICAL THERAPY |
| Practice Address |
6098 E Grand Prairie Dr Boise ID 83716-4700 |
| Practice Telephone | 2088131330 |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |
| Authorized Official Name | JANE ANNE MADDEN (OWNER/PHYSICAL THERAPIST) |
| Authorized Official Telephone | 2088131330 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
6098 E GRAND PRAIRIE DR |
| City | BOISE |
| State | ID |
| Zip Code | 83716-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659317899 | Jane Anne Madden | Physical Therapist | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2006-06-22 |
| 1710599816 | Proximity Telehealth LLC | Physical Therapist | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2020-08-19 |
| 1881180776 | Proximity Telehealth LLC | Clinic/Center | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2018-07-03 |
| 1487142279 | Proximity Physical Therapy LLC | Clinic/Center | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2018-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790294973 | The Pt Next Door | Clinic/Center | 6098 E. Grand Prairie Drive, Boise, ID 83716 | 2017-09-20 |
| 1326577610 | Koreen Boydstun | Specialist/Technologist | 3301 Sweetwater Dr, Boise, ID 83716 | 2017-06-08 |
| 1558806117 | Katie Palmer | Behavioral Analyst | 2939 S Shadywood Way, Boise, ID 83716 | 2017-01-05 |
| 1245680099 | Elaine Key Md Pllc | Anesthesiology | 3919 E Timbersaw Dr, Boise, ID 83716 | 2016-06-13 |
| 1174993463 | Daria Elizabeth Karas | Physician Assistant | 8000 S. Federal Way, Boise, ID 83716 | 2015-09-30 |
| 1407239973 | Humangood Idaho | Skilled Nursing Facility | 5301 E Warm Springs Ave, Boise, ID 83716 | 2015-07-02 |
| 1225460066 | Katherine Elizabeth Turnbull | Nurse Practitioner | 2051a E Summersweet Dr, Boise, ID 83716 | 2013-08-03 |
| 1134483845 | Karen D Lodge | Pharmacist | 5211 S Farmhouse Pl, Boise, ID 83716 | 2012-06-27 |
| 1730341827 | Christopher A Thomason | Dentist | 5898 S Quamash Way, Boise, ID 83716 | 2008-06-30 |
| 1861515637 | Tyler John Harrington | Dentist | 2033 E Summersweet Dr, Boise, ID 83716 | 2007-04-09 |
| Find all providers in zip 83716 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356964449 | Vibrant Physical Therapy & Wellness | Clinic/Center | 1111 S Orchard St Ste 104, Boise, ID 83705-1961 | 2020-05-22 |
| 1477193795 | Zona Physical Therapy | Clinic/Center | 11483 W Fairview Ave, Boise, ID 83713-7940 | 2020-01-15 |
| 1427565845 | Premier Physical Therapy Inc | Clinic/Center | 13967 W Wainwright Dr Ste 104, Boise, ID 83713-2094 | 2018-01-08 |
| 1790294973 | The Pt Next Door | Clinic/Center | 6098 E. Grand Prairie Drive, Boise, ID 83716 | 2017-09-20 |
| 1023381472 | Small Steps Pediatric Therapy, Pllc | Clinic/Center | 6180 W Emerald St, Boise, ID 83704 | 2012-02-15 |
| 1013206002 | Sawtooth Physical Therapy | Clinic/Center | 7979 W Rifleman St Ste 200, Boise, ID 83704-9066 | 2011-03-31 |
| 1144334525 | Intermountain Physical Therapy Limited Partnership | Clinic/Center | 554 Steelhead Way, Suite 162, Boise, ID 83704-8391 | 2006-08-19 |
| 1043855505 | Destinations Physical Therapy | Clinic/Center | 12951 W Goldenrod Ave, Boise, ID 83713-2510 | 2019-11-08 |
| 1881180776 | Proximity Telehealth LLC | Clinic/Center | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2018-07-03 |
| 1487142279 | Proximity Physical Therapy LLC | Clinic/Center | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2018-04-26 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.