SPECIALIZED PHYSICAL THERAPY PLLC (NPI# 1215381181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215381181 |
| Entity Type | Organization |
| Organization Name | SPECIALIZED PHYSICAL THERAPY PLLC |
| Practice Address |
4141 Poleline Rd Ste A Pocatello ID 83202 |
| Mailing Address |
4141 Poleline Rd Ste A Pocatello ID 83202-4904 |
| Practice Telephone | 2082428617 |
| Practice Fax Number | 8336982470 |
| Mailing Telephone | 2082428617 |
| Mailing Fax Number | 8336982470 |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2019-10-29 |
| Authorized Official Name | DR. SHAWN ROBERT HIGBEE (OWNER) |
| Authorized Official Telephone | 2082428617 |
| Authorized Official Credential | PT,DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT-3095 | ID | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 500 S 11th Ave Ste 304, Pocatello, ID 832014879 | 2081378556 | |
| 4141 Poleline Rd Ste A, Pocatello, ID 83202 | 2082428617 | 8336982470 |
| Street Address |
4141 POLELINE RD STE A |
| City | POCATELLO |
| State | ID |
| Zip Code | 83202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537196 | Jeremy Wayne Hegman | Clinic/Center | 4141 Poleline Rd Ste A, Pocatello, ID 83202-4904 | 2020-10-29 |
| 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 |
| 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 |
| 1417370842 | Chief Tahgee Elementary Academy, Inc. | Counselor | 38 S Hiline Rd, Pocatello, ID 83202 | 2014-01-21 |
| Find all providers in zip 83202 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710163803 | Allen Bennett Martin | Clinic/Center | 540 South Garfield, Pocatello, ID 83204 | 2008-01-18 |
| 1215537196 | Jeremy Wayne Hegman | Clinic/Center | 4141 Poleline Rd Ste A, Pocatello, ID 83202-4904 | 2020-10-29 |
| 1013423482 | Hands On Diagnostics of Idaho, Pllc | Clinic/Center | 1800 Flandro Dr Ste 190, Pocatello, ID 83202-4940 | 2017-12-21 |
| 1902098841 | Rapid Creek Rehab, PC | Clinic/Center | 1800 Garrett Way, Ste 19a, Pocatello, ID 83201-5132 | 2007-08-14 |
| 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 |
| 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 |
| 1225676372 | Mike Dusbabek Physical Therapy, Pllc | Clinic/Center | 609 S Dollar St, Coeur D Alene, ID 83814-3828 | 2019-12-19 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.