NPIMap

Organization Active NPI

Agility PT PLLC

  • Physical Therapist
  • Walla Walla, WA
National Provider Identifier
1124739693
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AGILITY PT PLLC
Practice address
614 E Alder St Ste 4
Walla Walla, WA 99362-2073
Phone
(509) 956-9047
NPI assigned
Dec 6, 2022
Organization subpart
No

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230316000804 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4183098015 Receives reassigned benefits from 2 practitioners
Practice locations: Walla Walla, WA

National Provider Directory

National Provider Directory

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Mr. Victor Keeno Attoh, DPTNPI 1689978660
Title
Owner
Phone
(509) 956-9047

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

614 E Alder St Ste 4
Walla Walla, WA 99362-2073

Mailing address

522 W Riverside Ave Ste N
Spokane, WA 99201-0580
Phone (509) 956-9047

Other names 1

  • Agility Physical Therapy Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1124739693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE N",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "509-956-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E ALDER ST STE 4",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622073",
            "telephone_number": "509-956-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGILITY PT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "ATTOH",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "KEENO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-956-9047",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agility Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Agility Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.