Brandon Phoenix Kallgren, DPT
NPI 1265317341ActiveIndividual· Physical Therapist· Idaho Falls, ID
Physical Therapist (DPT) with Pick PT Ammon LLC, practicing in Idaho Falls, Idaho. Enrolled in Medicare as practitioner - physical medicine and rehabilitation.
Overview
| NPI | 1265317341 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | Yes |
| NPI issued | Aug 8, 2025 |
| Last updated in NPPES | Aug 8, 2025 |
| Certified by provider | Aug 7, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 5171576 | ID |
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 Practitioner - Physical Medicine and Rehabilitation (ID) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Physical Medicine And Rehabilitation |
Medical group
- Pick PT Ammon LLCIdaho Falls, ID · 3 clinicians
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