CUSTOM REHAB LLC (NPI# 1215204862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215204862 |
| Entity Type | Organization |
| Organization Name | CUSTOM REHAB LLC |
| Practice Address |
265 E Chubbuck Rd Chubbuck ID 83202-5055 |
| Mailing Address |
857 Sheba Rd Chubbuck ID 83202-2522 |
| Practice Telephone | 2082441882 |
| Mailing Telephone | 2082441882 |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | JARED L MCKEE (OWNER) |
| Authorized Official Telephone | 2082441882 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
265 E CHUBBUCK RD |
| City | CHUBBUCK |
| State | ID |
| Zip Code | 83202-5055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083238877 | Ashlynn Hayden Oborn | Social Worker | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2020-06-08 |
| 1679107296 | Center Counseling, LLC | Specialist | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2020-02-24 |
| 1700425600 | Center Counseling, LLC | Peer Specialist | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-12-26 |
| 1679112502 | Center Counseling, LLC | Community/Behavioral Health | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-12-23 |
| 1376182204 | Center Counseling, LLC | Case Management | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-12-23 |
| 1831731215 | Jodie Lynn Barnes | Counselor | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-10-17 |
| 1821650250 | William Clayton Riggs | Counselor | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-07-06 |
| 1912562968 | Cynthia Louise Lange | Counselor | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-05-06 |
| 1346708948 | Temoc Rafael Torres | Counselor | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-03-04 |
| 1841720224 | Julianne Maria Andrysiak | Social Worker | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2017-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1649712597 | Angie M Mccurdy | Audiologist | 4155 Yellowstone Hwy, Pine Ridge Mall, Pocatello, ID 83202 | 2016-11-09 |
| 1285180836 | Beverly Grigg Jones | Counselor | 210 W. Burnside, Chubbuck, ID 83202 | 2016-09-01 |
| 1376992503 | Andrea Walsh | Nurse Practitioner | 1133 Call Creek Dr, Ste A, Pocatello, ID 83202 | 2016-06-08 |
| 1215381181 | Specialized Physical Therapy Pllc | Clinic/Center | 4141 Poleline Rd Ste A, Pocatello, ID 83202 | 2016-04-18 |
| 1457713588 | Jennifer Ann Gould | Radiologic Technologist | 907 Ryan Street, Chubbuck, ID 83202 | 2016-03-28 |
| 1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
| 1750781449 | Jennifer Lynn Seaich | Counselor | 4460 Center Way, Center Counseling, Pocatello, ID 83202 | 2014-08-29 |
| 1336562412 | Kurt Layton | Counselor | 337 Joel, Chubbuck, ID 83202 | 2014-01-27 |
| 1245653468 | Hannah's Place LLC | Occupational Therapist | 240 W Burnside Ave Ste D, Chubbuck, ID 83202 | 2014-01-23 |
| Find all providers in zip 83202 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427572957 | High Desert Physical Therapy LLC | Physical Therapist | 820 W. Chubbuck Rd, Chubbuck, ID 83202-2933 | 2017-07-26 |
| 1215365168 | Sarah Ingalls | Physical Therapist | 4425 Burley Dr, Chubbuck, ID 83202-1957 | 2013-10-30 |
| 1780952093 | Jerralyn R Wasylyshen | Physical Therapist | 4650 Hawthorne Rd Ste 2b, Chubbuck, ID 83202-2376 | 2011-12-01 |
| 1215088059 | Timothy Andrew Flicker | Physical Therapist | 4922 Yellowstone Ave Ste J, Chubbuck, ID 83202-2360 | 2007-01-16 |
| 1124196340 | Derrick Northrup | Physical Therapist | 605 Taylor Ln, Chubbuck, ID 83202-5169 | 2006-12-04 |
| 1124639653 | Sophia M Garrett | Physical Therapist | 265 E Chubbuck Rd Ste A, Chubbuck, ID 83202-5055 | 2020-08-10 |
| 1396374146 | Forza Physical Therapy Pllc | Physical Therapist | 605 Taylor Ln, Chubbuck, ID 83202-5169 | 2020-04-03 |
| 1144504812 | Flicker Physical Therapy LLC | Physical Therapist | 4922 Yellowstone Ave Ste J, Chubbuck, ID 83202-2360 | 2011-09-29 |
| 1578859054 | Cara Devoe | Physical Therapist | 4650 Hawthorne Rd Ste 3b, Chubbuck, ID 83202-2376 | 2011-06-23 |
| 1336438894 | Derek J Schelske | Physical Therapist | 4650 Hawthorne Rd, Ste 2b, Chubbuck, ID 83202-2376 | 2011-04-05 |
| Find all providers in CHUBBUCK | ||||
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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.