Individual provider Active NPI

Trinity Ann Parris, PT

  • Physical Therapist
  • Aberdeen, WA
National Provider Identifier
1104835560
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009307 Issued in WA
Practice address
220 W 1St St
Aberdeen, WA 98520-6216
Phone
(360) 533-3853
Fax
(360) 533-3310
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00009307 WA Primary

Addresses

Primary practice location

220 W 1St St
Aberdeen, WA 98520-6216

Mailing address

220 W 1St St
Aberdeen, WA 98520-6216

Other identifiers 3

IdentifierTypeStateIssuer
8378754MedicaidWA
9110PAOtherWAREGENCE BLUE SHIELD
0177264OtherWALABOR AND INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001702 WA Practitioner - Physical Therapist in Private Practice 5395738124 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00009307WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor Community Hospital Current Accepting new patients
Harbor Physical Therapy Services, PS Physical Therapist PastSince Jul 16, 2001 Accepting new patients

Locations

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

1006 N H St
Fl 3
Aberdeen, WA 98520
Phone (360) 533-6300

575 E Main St
Bldg A
Elma, WA 98541
Phone (360) 482-5640

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25026/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104835560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W 1ST ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W 1ST ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206216",
            "telephone_number": "360-533-3853",
            "fax_number": "360-533-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRIS",
        "first_name": "TRINITY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8378754",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "9110PA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0177264",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.