NPI age
19 years
Enumerated 2006-07-10
● Active Type 2 · Organization
Subpart
Integrated Rehabilitation Group, Pc
Integrated Rehabilitation Group, Pc is 1 of 120 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
O'Kelley
President/owner
Last NPPES update
2023-12-28
Source: monthly bulk 2026-05
How this organization compares
Across 120 active clinic/center providers in Idaho.
NPI age
19 years
↑ 11 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
150 126th St
Orofino, ID 835449386
Mailing address
4220 132nd St Se, Suite 101
Mill Creek, WA 980128999
Authorized official
Michael Shannon O'Kelley, MPT
President/owner
📞 4253168046
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Willian Marks, P.T. Physical Therapist NPI 1922268630
- Alison Thomas, PT Physical Therapist NPI 1356388151
Specialties
-
Clinic/Center PrimaryAn entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 10022782 | REGENCE BLUE SHIELD OF ID |
| 01 (WA) | T9057 | BLUE CROSS OF ID |
| 01 (WA) | CJ3511 | RAILROAD MEDICARE |
| 01 (WA) | 3791726-06 | OWCP |
| 05 (WA) | 807710200 | |
| 01 (WA) | 0129413 | DEPT. OF LABOR & INDUSTRY |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Riverside Physical Therapy
-
Riverside Physical Therapy
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
Subpart of Integrated Rehabilitation Group, Pc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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