Individual provider Active NPI

Adriana Luz Gonzalez-Medina, DPT

  • Physical Therapist
  • Bainbridge Island, WA
National Provider Identifier
1003283565
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60578159 Issued in WA
Practice address
840 Madison Ave N # 102
#102
Bainbridge Island, WA 98110-1769
Phone
(206) 855-0955
NPI assigned
Aug 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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 PT60578159 WA Primary

Addresses

Primary practice location

840 Madison Ave N # 102
#102
Bainbridge Island, WA 98110-1769

Mailing address

PO Box 10276
Bainbridge Island, WA 98110-0276
Phone (206) 369-2725

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1003283565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10276",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981100276",
            "telephone_number": "206-369-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 MADISON AVE N # 102",
            "address_2": "#102",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101769",
            "telephone_number": "206-855-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-MEDINA",
        "first_name": "ADRIANA",
        "middle_name": "LUZ",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60578159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.