Active NPI
James M Green PS
- Physical Therapist
- Bremerton, WA
National Provider Identifier
1104022409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00002393
- Legal business name
- JAMES M GREEN PS
- Practice address
- 900 Sheridan Rd.
#109
Bremerton, WA 98310-2701 - Phone
- (360) 377-3395
- Fax
- (360) 792-1249
- NPI assigned
- Jun 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James M Green, P.T.
- Title
- Owner/Physical Therapist
- Phone
- (360) 377-3395
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00002393 | WA | Primary |
Addresses
Primary practice location
900 Sheridan Rd.
#109
Bremerton, WA 98310-2701
Mailing address
900 Sheridan Rd.
#109
Bremerton, WA 98310-2701
Phone (360) 377-3395
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8141202 | Medicaid | WA | |
| WA7267008 | Medicaid | WA | |
| 190150200 | Other | WA | FEDERAL DEPT OF LABOR |
| 0197563 | Other | WA | STATE L&I |
Other names 1
- Bremerton Physical Therapy
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182556800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1226448000000",
"number": "1104022409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 SHERIDAN RD.",
"address_2": "#109",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983102701",
"telephone_number": "360-377-3395",
"fax_number": "360-792-1249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SHERIDAN RD.",
"address_2": "#109",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983102701",
"telephone_number": "360-377-3395",
"fax_number": "360-792-1249"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JAMES M GREEN PS",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-23",
"last_updated": "2008-11-12",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
"authorized_official_telephone_number": "360-377-3395",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "P.T."
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00002393",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8141202",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "WA7267008",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL DEPT OF LABOR",
"identifier": "190150200",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "0197563",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bremerton Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.