Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Tiffany Heather Maxwell, PTA

Individual provider Physical Therapy Assistant · NPI 1063268753

Mrs. Tiffany Heather Maxwell, PTA is a Physical Therapist in Private Practice in Idaho Falls, Idaho. Qualified in 2017, 9 years ago. Licensed in Idaho.

Years since qualifying
9
Licensed in
ID
In the registry since
2024
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

2037 E 17th St
Idaho Falls, ID 83404-6430
Phone: (208) 529-3355
Fax: (208) 529-9581
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA5326 (ID)

Record details

NPI number1063268753
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedApril 24, 2024
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

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