NPIMap

Organization Active NPI

Stanwood-Camano Physical Therapy, PLLC

  • Physical Therapist
  • Stanwood, WA
National Provider Identifier
1083721872
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007557 Issued in WA
Legal business name
STANWOOD-CAMANO PHYSICAL THERAPY, PLLC
Practice address
9612 270TH St NW Ste 103
Stanwood, WA 98292-1911
Phone
(360) 629-8043
Fax
(360) 629-8053
NPI assigned
Aug 25, 2006
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Landon Cook, PTNPI 1033649090
Title
Owner
Phone
(929) 547-6370

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 Therapist 225100000X PT00007557 WA Primary

Addresses

Primary practice location

9612 270TH St NW Ste 103
Stanwood, WA 98292-1911

Mailing address

9612 270TH St NW Ste 103
Stanwood, WA 98292-1911
Phone (360) 629-8043

Other identifiers 1

IdentifierTypeStateIssuer
1518960285MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070523000551 WA Part B Supplier - Clinic/Group Practice 7012014236 Receives reassigned benefits from 12 practitioners
Practice locations: Stanwood, WA

National Provider Directory

National Provider Directory

Locations

9612 270th St NW
Stanwood, WA 98292
Phone (360) 629-2000

9612 270th St NW
Ste D
Stanwood, WA 98292
Phone (360) 629-8043

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1083721872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9612 270TH ST NW STE 103",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982921911",
            "telephone_number": "360-629-8043",
            "fax_number": "360-629-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9612 270TH ST NW STE 103",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982921911",
            "telephone_number": "360-629-8043",
            "fax_number": "360-629-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANWOOD-CAMANO PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "LANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "929-547-6370",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518960285",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.