JUMP START PEDIATRIC THERAPY, LLC (NPI# 1144494105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144494105 |
| Entity Type | Organization |
| Organization Name | JUMP START PEDIATRIC THERAPY, LLC |
| Practice Address |
411 W Haycraft Ave Ste B3 Coeur D Alene ID 83815-8105 |
| Practice Telephone | 2086642468 |
| Practice Fax Number | 2086676239 |
| Mailing Telephone | 2086642468 |
| Mailing Fax Number | 2086676239 |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2012-01-30 |
| Authorized Official Name | MRS. ELLISON SANDERS (OWNER / PHYSICAL THERAPIST) |
| Authorized Official Telephone | 2086642468 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT-2061 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| REGENCE BLUE SHIELD | 000010164610 | 01 | |
| BLUE CROSS OF IDAHO | TD687 | 01 | |
| ID | 807908300 | 05 |
| Street Address |
411 W HAYCRAFT AVE STE B3 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83815-8105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275525297 | Gregory Vey Parsons | Chiropractor | 411 W Haycraft Ave, Ste D-1, Coeur D Alene, ID 83815-8105 | 2005-08-16 |
| 1750629937 | Elizabeth Wilson | Speech-Language Pathologist | 411 W Haycraft Ave, Suite D4, Coeur D Alene, ID 83815-8105 | 2013-01-23 |
| 1316202591 | Robyn Brown Zahand | Speech-Language Pathologist | 411 W Haycraft Ave, Ste D4, Coeur D Alene, ID 83815-8105 | 2012-07-12 |
| 1063716207 | Spokane Home Healthcare Inc | Durable Medical Equipment & Medical Supplies | 411 W Haycraft Ave, Suite B2, Coeur D Alene, ID 83815-8105 | 2011-01-03 |
| 1720276850 | Ellison Renee Sanders | Physical Therapist | 411 W Haycraft Ave, Ste B3, Coeur D Alene, ID 83815-8105 | 2007-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790133163 | Christine Lee Stanton | Speech-Language Pathologist | 3825 N. Blalock Drive, Coeur D'alene, ID 83815 | 2016-05-26 |
| 1578921961 | Kayla Wearne | Speech-Language Pathologist | 917 W Canfield Avenue, Coeur D'alene, ID 83815 | 2016-02-01 |
| 1770954794 | William Strong | Speech-Language Pathologist | 3902 Broken Arrow Rd, Coeur D Alene, ID 83815 | 2015-10-16 |
| 1235517079 | Denny Bordeaux | Emergency Medical Technician, Paramedic | 7294 Downing Lane, Coeur D Alene, ID 83815 | 2015-05-13 |
| 1689075657 | Barbara Campbell | Pharmacist | W 201 Neider Rd., Coeur D'alene, ID 83815 | 2014-09-10 |
| 1710313671 | Sean Cooper | Pharmacist | W. 201 Neider Rd., Coeur D' Alene, ID 83815 | 2013-09-23 |
| 1275871329 | Lake City Dental | Dentist | 6176 Government Way, Coeur D'alene, ID 83815 | 2013-01-24 |
| 1881972701 | A Better Personal Care Inc | In Home Supportive Care | 3115 N Government Way Ste 2, Coeur D'alene, ID 83815 | 2011-07-26 |
| 1013206895 | Robert Sperry | Pharmacist | 41650 W Maricopacg Hwy., Maricopa, AZ 83815 | 2011-04-01 |
| 1629304670 | Marciea W. Buckley | Social Worker | 109 Harrison Ave, Coeur D' Alene, ID 83815 | 2009-10-27 |
| Find all providers in zip 83815 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376150581 | Meridian Mama's Physical Therapy | Clinic/Center | 309 W Emma Ave, Coeur D Alene, ID 83814-2522 | 2020-09-30 |
| 1225676372 | Mike Dusbabek Physical Therapy, Pllc | Clinic/Center | 609 S Dollar St, Coeur D Alene, ID 83814-3828 | 2019-12-19 |
| 1336604958 | Taylor Mobile Therapy, LLC | Clinic/Center | 5925 W Riverview Dr, Coeur D Alene, ID 83814-7705 | 2019-02-07 |
| 1215461793 | Elite Sports and Orthopedic Physical Therapy LLC | Clinic/Center | 852 W Kathleen Ave, Coeur D Alene, ID 83815-9405 | 2017-04-12 |
| 1912039983 | Physiotherapy Associates | Clinic/Center | 2190 Ironwood Pl, Suite B, Coeur D Alene, ID 83814-2610 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 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 |
| 1922665934 | Dahle Physical Therapy, Pllc | Clinic/Center | 812 Shoup St., Salmon, ID 83467-4305 | 2019-05-24 |
| 1598222713 | Salmon Speech and Swallowing Service | Clinic/Center | 700 Riverfront Dr Rm 1, Salmon, ID 83467-5190 | 2019-02-24 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 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 |
| 1215381181 | Specialized Physical Therapy Pllc | Clinic/Center | 4141 Poleline Rd Ste A, Pocatello, ID 83202 | 2016-04-18 |
| 1881938777 | North Star Physical Therapy and Wellness | Clinic/Center | 8944 N. Hess St, Suite B, Hayden, ID 83835 | 2012-11-16 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83815 |
Please comment or provide details below to improve the information on JUMP START PEDIATRIC THERAPY, LLC.
| 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.