Foothills Rehabilitation & Performance Services, PLLC
NPI 1063829836ActiveOrganization· Physical Therapist· Idaho Falls, ID
Physical Therapist in Idaho Falls, Idaho, registered in NPPES in July 2014. The authorized official on file is Brent Kennedy, DPT, Owner/Manager. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1063829836 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 14, 2014 |
| Last updated in NPPES | Sep 5, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT-1740 | ID |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (ID) |
|---|
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