JOHN STAVAST (NPI# 1982050894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982050894 |
| Entity Type | Individual |
| Full Name | JOHN STAVAST |
| Credential | DPT |
| Practice Address |
2640 Channing Way Idaho Falls ID 83404-7517 |
| Practice Telephone | 2085522248 |
| Mailing Telephone | 2085522248 |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT - 4630 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2640 CHANNING WAY |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-7517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013953462 | Jeremy L Jones | Physical Therapist | 2640 Channing Way, Idaho Falls, ID 83404-7517 | 2006-06-22 |
| 1982201661 | Jace Christian Briggs | Physical Therapist | 2640 Channing Way, Idaho Falls, ID 83404-7517 | 2020-10-06 |
| 1568020279 | Kevin Michael Kula | Physical Therapist | 2640 Channing Way, Idaho Falls, ID 83404-7517 | 2019-05-29 |
| 1184042129 | Michael Rupp | Physical Therapist | 2640 Channing Way, Idaho Falls, ID 83404-7517 | 2014-04-06 |
| 1841595923 | Zachary Lucas Daniels | Physical Therapist | 2640 Channing Way, Idaho Falls, ID 83404-7517 | 2011-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851645634 | Joseph Monte Wight | Physical Therapist | 2037 E 17th St, Idaho Falls, ID 83404-6430 | 2012-11-01 |
| 1053633313 | Teton Physical Therapy, Inc | Physical Therapist | 2037 E 17th St, Idaho Falls, ID 83404-6430 | 2010-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878341 | Mckenna Briane Young | Physical Therapist | 910 Nw 16th St Ste 200, Fruitland, ID 83619-2265 | 2020-07-17 |
| 1235750746 | Sol Physiotherapy LLC | Physical Therapist | 804 N Whitley Dr, Fruitland, ID 83619-2437 | 2020-05-06 |
| 1205307485 | Scoliosis Treatment Center of Idaho | Physical Therapist | 2157 S Pebblecreek Ln, Boise, ID 83706-6123 | 2018-12-16 |
| 1972027431 | Robert Bernard Wendt | Physical Therapist | 904 White Ave, Moscow, ID 83843-3932 | 2017-07-26 |
| 1588924724 | Kevin Cherry | Physical Therapist | 243 Idaho St., Suite A, Gooding, ID 83330-1258 | 2012-05-22 |
| 1811107394 | Kathleen Alexander | Physical Therapist | Mail Stop 8045, Pocatello, ID 83209-8045 | 2007-05-23 |
| 1912116682 | Rulin J Hawks | Physical Therapist | 1902 S 10th Ave, Caldwell, ID 83605-4841 | 2007-05-21 |
| 1013137850 | Mark Morgan | Physical Therapist | 221 S River St, Hailey, ID 83333-8436 | 2007-04-26 |
| 1437210853 | Judith Lee Grucella | Physical Therapist | 4477 Emerald St Ste C125, Boise, ID 83706-2058 | 2006-12-12 |
| 1598862757 | David Marshal Saelens | Physical Therapist | 3322 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.