NPIMap

Organization Active NPI

Kitsap Physical Therapy and Sports Clinic PS Inc

  • Occupational Therapist
  • Silverdale, WA
National Provider Identifier
1104592518
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC
Practice address
2400 NW Myhre Rd Ste 102
Silverdale, WA 98383-7672
Phone
(360) 613-1834
NPI assigned
Aug 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Summer Zumwalt
Title
HRD
Phone
(360) 598-3764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

2400 NW Myhre Rd Ste 102
Silverdale, WA 98383-7672

Mailing address

2400 NW Myhre Rd Ste 101
Silverdale, WA 98383-7672
Phone (360) 598-3764

National Provider Directory

National Provider Directory
Tax ID family
Kitsap PT and Sports Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

Practitioners & affiliated clinicians

Practitioners 1

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": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1104592518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NW MYHRE RD STE 101",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837672",
            "telephone_number": "360-598-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NW MYHRE RD STE 102",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837672",
            "telephone_number": "360-613-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "ZUMWALT",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_title_or_position": "HRD",
        "authorized_official_telephone_number": "360-598-3764"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.