Physical Therapy for Kids, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PHYSICAL THERAPY FOR KIDS, LLC

Practice address

1109 N Forest Edge Dr
Sisters, OR 97759-2692

Phone

(907) 346-4096

Fax

(877) 319-7365

NPI assigned

Sep 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Sharon Skidmore, P.T., D.P.T.NPI 1215036751

Title

Owner

Phone

(907) 346-4096

Specialties & licenses 3

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sharon B Skidmore, P.T., D.P.T.

  • Physical Therapist
  • Sisters, OR
  • NPI 1215036751
  NPD Authorized official

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1013240175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977591475",
            "telephone_number": "907-346-4096",
            "fax_number": "907-346-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N FOREST EDGE DR",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977592692",
            "telephone_number": "907-346-4096",
            "fax_number": "877-319-7365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4325 Laurel St",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085364",
            "country_code": "US",
            "telephone_number": "907-346-4096",
            "fax_number": "907-346-4097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICAL THERAPY FOR KIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-08",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-346-4096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.T., D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "783",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AK",
            "license": "783",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500791711",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021227",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Sisters, OR
• Providers in Sisters, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.