Individual provider Active NPI

Jordan Mugarura, DPT, CSCS

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1114645512
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61333125 Issued in WA
Practice address
1100 N 35TH St
Seattle, WA 98103-8906
Phone
(206) 309-3966
NPI assigned
Aug 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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 PT61333125 WA Primary

Addresses

Primary practice location

1100 N 35TH St
Seattle, WA 98103-8906

Mailing address

1100 N 35TH St
Seattle, WA 98103-8906
Phone (206) 390-3966

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT61333125WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mugarura Physical Therapy & Wellness PLLC Current Accepting new patients
Experience Momentum, Inc - Fremont Physical Therapist PastSince Aug 28, 2022 Accepting new patients

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1114645512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N 35TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038906",
            "telephone_number": "206-390-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N 35TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038906",
            "telephone_number": "206-309-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGARURA",
        "first_name": "JORDAN",
        "credential": "DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61333125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.