Individual provider Active NPI

Jane Ellen Baumgartner, PT

  • Physical Therapist
  • Bothell, WA
National Provider Identifier
1003150558
Registry record updated Nov 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 00002605 Issued in WA
Practice address
3330 Monte Villa Pkwy
Bothell, WA 98021-8972
Phone
(425) 408-6000
NPI assigned
Nov 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 00002605 WA Primary

Addresses

Primary practice location

3330 Monte Villa Pkwy
Bothell, WA 98021-8972

Mailing address

6207 NE 191St St
Kenmore, WA 98028-3372
Phone (425) 483-9229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT 00002605WAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353542400000",
    "number": "1003150558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 NE 191ST ST",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980283372",
            "telephone_number": "425-483-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 MONTE VILLA PKWY",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218972",
            "telephone_number": "425-408-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARTNER",
        "first_name": "JANE",
        "middle_name": "ELLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-22",
        "last_updated": "2012-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 00002605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.