NPI Lens

Advanced Physical Therapy & Wound Center, PLLC

NPI 1356754147ActiveOrganization· Physical Therapist· Rexburg, ID

Physical Therapist in Rexburg, Idaho, registered in NPPES in June 2014. The authorized official on file is Alicia Siddoway, P.T., Director Of Therapy. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.

Overview

NPI1356754147
StatusActive
Entity typeOrganization
NPI issuedJun 9, 2014
Last updated in NPPESJun 11, 2015

Specialties and licenses

TaxonomyCodeLicenseState
Physical Therapist Primary225100000X——
Occupational Therapy Assistant224Z00000X——
Physical Therapy Assistant225200000X——
Occupational Therapist225X00000X——
Audiologist231H00000X——
Speech-Language Pathologist235Z00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No 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)

Medicare sources and data years

Other Physical Therapist providers in Rexburg

All Physical Therapist providers in Idaho →