MEDICARE: MRS. THERESA M BARON PT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2581001	ID
2	225100000X	Physical Therapist	4433-024	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00920594	OTHER	IL	MEDICARE RAILROAD
2	000080070	OTHER	WI	MEDICARE GROUP NUMBER
4	P00248075	OTHER	WI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861475220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THERESA M BARON PT, ATC

Provider Business Mailing Address
First Line	:	1593 E POLSTON AVE
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-5326
Country	:	US
Telephone Number	:	208-262-2300
Fax Number	:	208-262-2390

Provider Business Practice Location Address
First Line	:	7600 N MINERAL DR STE 111
Second Line	:
City	:	COEUR D ALENE
State	:	ID
Zip	:	83815-7763
Country	:	US
Telephone Number	:	208-457-4208
Fax Number	:	208-457-4197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	06/03/2026

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Directions to “ MRS. THERESA M BARON PT, ATC” Practice Location

Language	Start Address	Practice Location

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