PEDIATRIC DEVELOPMENT CLINIC (NPI# 1326443607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326443607 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DEVELOPMENT CLINIC |
| Other Organization Name | PDC |
| Practice Address |
4846 Wind River Rd Idaho Falls ID 83401-5828 |
| Mailing Address |
Po Box 365 Iona ID 83427-0365 |
| Practice Telephone | 2083397234 |
| Practice Fax Number | 2085520935 |
| Mailing Telephone | 2083397234 |
| Mailing Fax Number | 2085520395 |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |
| Authorized Official Name | MR. JAMES A KING (PRESIDENT) |
| Authorized Official Telephone | 2083397234 |
| Authorized Official Credential | MS, OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
ID | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PDC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346286895 | Pediatric Development Clinic | Pediatrics | 601 Elmwood Ave, Box 635, Rochester, NY 14642-0001 | 2006-06-22 |
| Street Address |
4846 WIND RIVER RD |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-5828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538355532 | James Albert King | Occupational Therapist | 4846 Wind River Rd, Idaho Falls, ID 83401-5828 | 2007-09-24 |
| 1821491424 | Renaissance Rehab | Physical Therapist | 4846 Wind River Rd, Idaho Falls, ID 83401-5828 | 2014-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1609068295 | Sterling Management and Consulting, LLC | Clinic/Center | 5412 S House Rock Cir, Idaho Falls, ID 83406-8336 | 2007-08-16 |
| 1881226652 | Strider Physical Therapy | Clinic/Center | 3155 Channing Way Ste A, Idaho Falls, ID 83404-7875 | 2020-02-10 |
| 1821628645 | Ellis Physical Therapy and Associates LLC | Clinic/Center | 3100 S Woodruff Ave, Idaho Falls, ID 83404-8310 | 2020-01-21 |
| 1649449430 | Eagle Rock Physical Therapy | Clinic/Center | 1542 Elk Creek Dr, Suite B, Idaho Falls, ID 83404-8322 | 2008-02-26 |
| 1174712418 | Eagle Rock Physical Therapy Pllc | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2007-10-23 |
| 1831211093 | Foothills Rehabilitation & Performance Services | Clinic/Center | 3814 Washington Pkwy, Idaho Falls, ID 83404-7591 | 2007-04-06 |
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
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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.