Individual provider Active NPI

Misty Manherz, PTA

  • Physical Therapy Assistant
  • Bellingham, WA
National Provider Identifier
1063168292
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
60551536 Issued in WA
Practice address
4029 Northwest Ave Ste 302
Bellingham, WA 98226-9077
Phone
(360) 734-2277
NPI assigned
Feb 25, 2022
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 60551536 WA Primary

Addresses

Primary practice location

4029 Northwest Ave Ste 302
Bellingham, WA 98226-9077

Mailing address

4029 Northwest Ave Ste 302
Bellingham, WA 98226-9077
Phone (360) 734-2277

Other practice location 1

1863 Main St Ste 101
Ferndale, WA 98248-9059
Phone (360) 656-6534

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
60551536WAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Physical Therapy Inc. CurrentSince Feb 27, 2022 Accepting new patients
Excel Physical Therapy Inc PastSince Feb 27, 2022 Accepting new patients

Locations

4029 Northwest Ave
Ste 302
Bellingham, WA 98226
Phone (360) 734-2277

1863 Main St
Ste 101
Ferndale, WA 98248
Phone (360) 656-6534

Organizations & group practices 2

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1063168292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE STE 302",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077",
            "telephone_number": "360-734-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE STE 302",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077",
            "telephone_number": "360-734-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1863 Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ferndale",
            "state": "WA",
            "postal_code": "982489059",
            "country_code": "US",
            "telephone_number": "360-656-6534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANHERZ",
        "first_name": "MISTY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "60551536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.