Brad S Defenbaugh, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60273792 Issued in WA

Practice address

1 Lake Bellevue Dr
Ste 100
Bellevue, WA 98005-2417

Phone

(425) 462-4330

Fax

(425) 462-4335

NPI assigned

Feb 24, 2009

Last updated

Nov 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Center for Sports Medicine & Physical Therapy Inc

  dba Northwest Sports Physical Therapy

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  NPD
• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Moline, IL
  • NPI 1245373166
  NPD (past)
• Rock Valley Physical Therapy Center

  • Occupational Therapist
  • Eldridge, IA
  • NPI 1881540490

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1134369671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAKE BELLEVUE DR",
            "address_2": "STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052417",
            "telephone_number": "425-462-4330",
            "fax_number": "425-462-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAKE BELLEVUE DR",
            "address_2": "STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052417",
            "telephone_number": "425-462-4330",
            "fax_number": "425-462-4335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13315 68th Pl NE",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980341650",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFENBAUGH",
        "first_name": "BRAD",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60273792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PT LICENSE",
            "identifier": "070016925",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genenvieve Decantis, SLP
• Anthony Decicco, PHARMD
• Kathleen P Decker, M.D.
• Tammy Kay Decorte, GCFP
• Jessica Deer, MS, RDN, CD
• Kaitlynn Ann Defreitas, CBT
• Cherie A Degala, LMP
• Alexandra L. Degroot, AUD
• Deichert Integrative Health LLC
• David Deichert, ND, ARNP

• Physical Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.