Active NPI
Steven G Wittrock, PT
- Orthopedic Physical Therapist
- Des Moines, WA
National Provider Identifier
1104823129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT00002055
- Practice address
- 22659 Pacific Hwy S
Des Moines, WA 98198-5155 - Phone
- (206) 824-3668
- Fax
- (206) 824-3964
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT00002055 | WA | Primary |
Addresses
Primary practice location
22659 Pacific Hwy S
Des Moines, WA 98198-5155
Mailing address
27431 12TH PL S
Des Moines, WA 98198-9418
Phone (253) 838-2464
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15613 | Other | WA | DEPT OF LABOR & INDUSTRIE |
| 8378366 | Medicaid | WA |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Physical Therapy LLC | Orthopedic | Past | Accepting new patients |
| Highline Physical Therapy Group | Past | Accepting new patients | |
| Alliance Physical Therapy LLC | Orthopedic | Past | Accepting new patients |
| Alliance Physical Therapy, LLC | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopedic Physical Therapist
- Federal Way, WA
- NPI 1891838702
-
- Physical Therapist
- Federal Way, WA
- NPI 1215032701
-
- Orthopedic Physical Therapist
- Des Moines, WA
- NPI 1831232651
-
- Physical Therapist
- Burien, WA
- NPI 1477797991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104823129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27431 12TH PL S",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981989418",
"telephone_number": "253-838-2464",
"fax_number": "253-838-4991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22659 PACIFIC HWY S",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981985155",
"telephone_number": "206-824-3668",
"fax_number": "206-824-3964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTROCK",
"first_name": "STEVEN",
"middle_name": "G",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "WA",
"license": "PT00002055",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRIE",
"identifier": "15613",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8378366",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.