Individual provider Active NPI

Anna Hardesty, PT

  • Physical Therapist
  • Grand Coulee, WA
National Provider Identifier
1003274614
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60598621 Issued in WA
Practice address
411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone
(509) 633-3260
Fax
(509) 633-3212
NPI assigned
Feb 10, 2016
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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 PT60598621 WA Primary

Addresses

Primary practice location

411 Fortuyn Rd
Grand Coulee, WA 99133-8718

Mailing address

411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone (509) 633-3260

Other identifiers 1

IdentifierTypeStateIssuer
2055346MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160309000401 WA Practitioner - Physical Therapist in Private Practice 6709182256 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60598621WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 Current Accepting new patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 CurrentSince Feb 17, 2020 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Feb 4, 2016 Accepting new patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 CurrentSince Feb 17, 2020 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist Current Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Feb 4, 2016 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

411 Fortuyn Rd
Grand Coulee, WA 99133
Phone (509) 633-1753

25012 104th Ave SE
Ste C
Kent, WA 98030
Phone (253) 856-3477

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

Interoperability endpoints

  • Direct secure messaging: hardesa@cmccares.cernerdirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/f18be9cb-2758-4a4b-a2a6-5e5131bfb5bc/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1003274614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FORTUYN RD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991338718",
            "telephone_number": "509-633-3260",
            "fax_number": "509-633-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FORTUYN RD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991338718",
            "telephone_number": "509-633-3260",
            "fax_number": "509-633-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDESTY",
        "first_name": "ANNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60598621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2055346",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Coulee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.