JACKSON HOLE PHYSICAL THERAPY, PC (NPI# 1952484511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952484511 |
| Entity Type | Organization |
| Organization Name | JACKSON HOLE PHYSICAL THERAPY, PC |
| Practice Address |
4030 Lake Creek Dr N Wilson WY 83014-9689 |
| Mailing Address |
Po Box 1828 Jackson WY 83001-1828 |
| Practice Telephone | 3077345292 |
| Practice Fax Number | 3077348834 |
| Mailing Telephone | 3077345292 |
| Mailing Fax Number | 3077348834 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-11-27 |
| Authorized Official Name | TAMARA HARMON (ADMINISTRATOR) |
| Authorized Official Telephone | 3077345292 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | BLUE CROSS OF WY | 05915001 | 01 |
| Street Address |
4030 LAKE CREEK DR N |
| City | WILSON |
| State | WY |
| Zip Code | 83014-9689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487737102 | Scott E Harmon | Physical Therapist | 4030 Lake Creek Dr N, Wilson, WY 83014-9689 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551633 | Keith Ryan Knudson | Physical Therapist | 1230 North Fall Creek Rd, Wilson, WY 83014 | 2020-09-03 |
| 1578121588 | Nina Clark Lex | Physical Therapist | 1230 N Fall Creek Rd, Wilson, WY 83014 | 2019-06-04 |
| 1659840403 | Hannah Lee Tripp | Dietitian, Registered | 1440 N West St., Wilson, WY 83014 | 2018-11-21 |
| 1902307952 | Joseph Anthony Sorge | Medical Genetics | 5320 Pine Meadow Road, Wilson, WY 83014 | 2018-02-26 |
| 1184174393 | Dean Woodmencey | Specialist | 4030 West Lake Creek Dr., Wilson, WY 83014 | 2016-10-12 |
| 1740657261 | Peter Moffatt | Counselor | 7905 South Fall Creek Road, Wilson, WY 83014 | 2015-09-01 |
| 1669722419 | Jeremy Silcox | Social Worker | 7905 Fall Creek Rd., Wilson, WY 83014 | 2012-09-19 |
| 1649533811 | Harriet Elizabeth Wardle | Social Worker | 3850 N Wilderness Dr, Wilson, WY 83014 | 2012-06-21 |
| 1205197043 | Laura Lea Perez | Psychologist | 3850 North Wilderness Dr., Wilson, WY 83014 | 2012-06-07 |
| 1306105689 | William Douglas Odell | Specialist | 5445 Cottonwood Canyon Road, Wilson, WY 83014 | 2012-05-08 |
| Find all providers in zip 83014 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578121588 | Nina Clark Lex | Physical Therapist | 1230 N Fall Creek Rd, Wilson, WY 83014 | 2019-06-04 |
| 1144744517 | Sara Lynn Campbell | Physical Therapist | 3200 Nash Street North, Wilson, NC 27896 | 2017-07-27 |
| 1912038209 | Linda K S Roberson | Physical Therapist | 1803 Forest Hills Road, Wilson, NC 27893 | 2007-03-08 |
| 1558469585 | Douglas Franklin Stewart | Physical Therapist | 1803 Forest Hills Rd W, Wilson, NC 27893-3412 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073120358 | Forge Physio and Performance LLC | Physical Therapist | 1095 Broadway St, Sheridan, WY 82801-3054 | 2020-09-30 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1386000727 | Taylor Lindsey | Physical Therapist | 1090 S Us Hwy 89, Jackson, WY 83001 | 2016-01-14 |
| 1144579731 | Move On Physical Therapy, Inc. | Physical Therapist | 1201 E. 7th Street, Powell, WY 82435 | 2012-08-29 |
| 1588744049 | Celeste Scheer | Physical Therapist | 800 E 20th St Ste 300, Cheyenne, WY 82001-3882 | 2006-10-17 |
| 1538274113 | Daniel E Fox | Physical Therapist | 4028 Laramie St, Cheyenne, WY 82001-2064 | 2006-08-21 |
| 1336151265 | Wyoming Specialized Physical Therapy | Physical Therapist | 620 West Cheyenne Dr., Evanston, WY 82930-5359 | 2006-08-12 |
| 1386286433 | Andrea Williams | Physical Therapist | 214 E 23rd St, Cheyenne, WY 82001-3748 | 2019-10-10 |
| 1689145484 | Kyle Graves | Physical Therapist | 1211 S Douglas Hwy Ste 100, Gillette, WY 82716-4982 | 2018-12-06 |
| 1639658990 | George Douglas Hayden IIi | Physical Therapist | 555 E Broadway Ave # 100, Jackson, WY 83001-8640 | 2018-08-08 |
| 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.