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

Stephanie Liddle, PT

Individual provider Athletic Trainer · NPI 1942489794

Stephanie Liddle, PT is a Physical Therapist in Private Practice in Idaho Falls, Idaho. Qualified in 1995, 31 years ago. Practices with Performance Therapy, LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
31
Licensed in
ID
In the registry since
2007
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

3125 Valencia Dr
Idaho Falls, ID 83404-7575
Phone: (208) 529-3332
Fax: (208) 529-3336
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT-954 (ID)
Athletic Trainer Taxonomy 2255A2300X · Licence AT-077 (ID)

Record details

NPI number1942489794
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedOctober 29, 2007
Last updated in NPPESMarch 14, 2023
Certification dateMarch 14, 2023
Mailing address1940 S Bonito Way Ste 190, Meridian, ID 83642-5618

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Performance Therapy, Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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