NPI age
19 years
Enumerated 2007-02-02
● Active
Type 1 · Individual
Robert Grant Black, PT
Black is 1 of 116 physical therapist providers in Pocatello and 1 of 2006 in Idaho.
Primary specialty
Physical Therapist
Plus 1 subspecialty
Licensed in
UT, ID
2 states
Status
Active
No deactivations on record
Last NPPES update
2008-08-20
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 2006 active physical therapist providers in Idaho.
NPI age
19 years
↑ 8 yr above median (11 yr)
State licenses
2 states
Top 91% — 9% of peers are multi-state
Subspecialties
1
In the 16% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-02Enumerated in NPPES
2007
2026
Where they practice
Practice location
285 Vista Drive, Suite A
Pocatello, ID 83201
Mailing address
2176 E. Franklin Road, Suite 100
Meridian, ID 836429024
Specialties
-
Physical Therapist PrimaryPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities...
-
SpecialistAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (UT) | D4888 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.