Organization Active NPI

Sports Reaction Center Inc

  • Specialist
  • Bellevue, WA
National Provider Identifier
1114073194
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT00002855 Issued in WA
Legal business name
SPORTS REACTION CENTER INC
Practice address
1750 112TH Ave NE
Suite D-154
Bellevue, WA 98004-3752
Phone
(425) 643-9778
Fax
(425) 643-6448
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Mr. Neil Chasan, PT
Title
President
Phone
(425) 643-9778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X PT00002855 WA Primary

Addresses

Primary practice location

1750 112TH Ave NE
Suite D-154
Bellevue, WA 98004-3752

Mailing address

1750 112TH Ave NE
Suite D-154
Bellevue, WA 98004-3752
Phone (425) 643-9778

Other identifiers 1

IdentifierTypeStateIssuer
1649232588OtherWAINDIVIDUAL UPN

National Provider Directory

National Provider Directory

Locations

1705 136th Pl NE
Ste 210
Bellevue, WA 98005
Phone (425) 643-9776

17735 NE 65th St
Redmond, WA 98052
Phone (428) 883-4060

Practitioners & affiliated clinicians

Practitioners 2

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1114073194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE",
            "address_2": "SUITE D-154",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043752",
            "telephone_number": "425-643-9778",
            "fax_number": "425-643-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE",
            "address_2": "SUITE D-154",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043752",
            "telephone_number": "425-643-9778",
            "fax_number": "425-643-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS REACTION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "CHASAN",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-643-9778",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "PT00002855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL UPN",
            "identifier": "1649232588",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.