Charla-jo Olorenshaw Spradlin, PT is a medicare enrolled "Physical Therapist" provider in Athol, Idaho. Her current practice location is
26453 N Old Highway 95, Athol, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 597-4595.
Charla-jo Olorenshaw Spradlin is licensed to practice in Idaho (license number PT-425) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1720390347.
Healthcare Provider's Profile
| Full Name | Charla-jo Olorenshaw Spradlin |
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| Gender | Female |
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| Speciality | Physical Therapist |
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| Location | 26453 N Old Highway 95, Athol, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1720390347
- Provider Enumeration Date: 07/12/2010
- Last Update Date: 01/23/2019
Medicare PECOS Information:
- PECOS PAC ID: 9739623232
- Enrollment ID: I20240625004012
Medical Identifiers
Medical identifiers for Charla-jo Olorenshaw Spradlin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720390347 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | PT-425 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charla-jo Olorenshaw Spradlin allows following entities to bill medicare on her behalf.
| Provider Name | Sonny Physical Therapy Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1992235816
PECOS PAC ID: 0345512596
Enrollment ID: O20170822004149 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charla-jo Olorenshaw Spradlin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Charla-jo Olorenshaw Spradlin, PT
26453 N Old Highway 95,
Athol, ID 83801-7076
Ph: (208) 597-4595 | Charla-jo Olorenshaw Spradlin, PT
26453 N Old Highway 95,
Athol, ID 83801-7076
Ph: (208) 597-4595 |
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