Organization Active NPI

Orcas Island Physical Therapy, PLLC

  • Physical Therapist
  • Eastsound, WA
National Provider Identifier
1073539151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ORCAS ISLAND PHYSICAL THERAPY, PLLC
Practice address
7 Deye LN
Eastsound, WA 98245-8578
Phone
(360) 376-6604
Fax
(360) 376-4059
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Andrew B. Stephens, PT, ATCNPI 1205855962
Title
Sole Member
Phone
(360) 376-6604

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

7 Deye LN
Eastsound, WA 98245-8578

Mailing address

7 Deye LN
Eastsound, WA 98245-8578
Phone (360) 376-6604

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426001442 WA Part B Supplier - Clinic/Group Practice 9537156302 Receives reassigned benefits from 3 practitioners
Practice locations: Eastsound, WA

National Provider Directory

National Provider Directory

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073539151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DEYE LN",
            "city": "EASTSOUND",
            "state": "WA",
            "postal_code": "982458578",
            "telephone_number": "360-376-6604",
            "fax_number": "360-376-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 DEYE LN",
            "city": "EASTSOUND",
            "state": "WA",
            "postal_code": "982458578",
            "telephone_number": "360-376-6604",
            "fax_number": "360-376-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCAS ISLAND PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "360-376-6604",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastsound, WA

Sources for this page

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