Individual provider Active NPI

Denise Fusso, BS

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1053359679
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7883 Issued in WA
Practice address
805 Broadway
Vancouver, WA 98660
Phone
(360) 823-0138
Fax
(360) 823-0141
NPI assigned
Jun 4, 2006
Last updated
Sep 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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 7883 WA Primary

Addresses

Primary practice location

805 Broadway
Vancouver, WA 98660

Mailing address

12515 NE 5TH CT
Vancouver, WA 98685
Phone (360) 573-2825

Other names 1

  • Ms. Den Fusso Other name

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
7883WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Orthopedic and Sports Physical Therapy of Vancouver, LLC Past Accepting new patients

Organizations & group practices 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1053359679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12515 NE 5TH CT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98685",
            "telephone_number": "360-573-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 BROADWAY",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98660",
            "telephone_number": "360-823-0138",
            "fax_number": "360-823-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSO",
        "first_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "7883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEN",
            "last_name": "FUSSO",
            "prefix": "MS.",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.