Kitsap Physical Therapy and Sports Clinic PS Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC

Practice address

19505 7TH Ave NE
Poulsbo, WA 98370-7700

Phone

(360) 779-7779

Fax

(360) 598-3282

NPI assigned

Apr 13, 2021

Last updated

May 10, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

KITSAP PHYSICAL THERAPY AND SPORTS CLINICS PS INCAs reported in NPPES

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

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Durable Medical Equipment & Medical Supplies
  • Bainbridge Island, WA
  • NPI 1154901437

  6507762333

  Same PAC ID
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Durable Medical Equipment & Medical Supplies
  • Silverdale, WA
  • NPI 1699355446

  6507762333

  Same PAC ID
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Durable Medical Equipment & Medical Supplies
  • Kingston, WA
  • NPI 1700466083

  6507762333

  Same PAC ID
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Physical Therapist
  • Silverdale, WA
  • NPI 1912902347

  6507762333

  Same PAC ID

Part of

Kitsap PT and Sports CL

Locations

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620604800000",
    "number": "1114507068",
    "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",
            "fax_number": "360-598-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19505 7TH AVE NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707700",
            "telephone_number": "360-779-7779",
            "fax_number": "360-598-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KITSAP PHYSICAL THERAPY AND SPORTS CLINICS PS INC",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kitsap Chiropractors PLLC (Ryan Chiropractic Clinic / Delong Chiropractic Clinic)
• Kitsap County Fire District 18
• Kitsap Dental
• Kitsap Eyecare Centers Inc PS (Poulsbo Eyecare Center)
• Kitsap Gastro and Liver Clinic, PLLC
• Joseph Knapp
• Sophie Knapp, CN, CNS
• Amanda Rose Knight
• Taylor Jean Knight, AU.D.
• Anne Knodel

• Durable Medical Equipment & Medical Supplies in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.