NPIMap

Organization Active NPI

Frontier Therapy LLC

Doing business as Kitsap Physical Therapy and Sports Clinics

  • Physical Therapist
  • Port Orchard, WA
National Provider Identifier
1154357150
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FRONTIER THERAPY LLC
Doing business as
Kitsap Physical Therapy and Sports Clinics
Practice address
1880 Pottery Ave
Ste 100
Port Orchard, WA 98366-2518
Phone
(360) 895-9090
Fax
(360) 895-9089
NPI assigned
Jun 23, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Mr. John Robert Carlson, PTNPI 1811949654
Title
Owner
Phone
(360) 895-9090

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 Therapist 225100000X NU Primary

Addresses

Primary practice location

1880 Pottery Ave
Ste 100
Port Orchard, WA 98366-2518

Mailing address

1880 Pottery Ave
Ste 100
Port Orchard, WA 98366
Phone (360) 895-9090

Other identifiers 2

IdentifierTypeStateIssuer
7105166MedicaidWA
0150495OtherWAWA DEPT OF LNI

Other names 1

  • Kitsap Physical Therapy and Sports Clinics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1154357150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 POTTERY AVE",
            "address_2": "STE 100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "98366",
            "telephone_number": "360-895-9090",
            "fax_number": "360-895-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 POTTERY AVE",
            "address_2": "STE 100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662518",
            "telephone_number": "360-895-9090",
            "fax_number": "360-895-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-895-9090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105166",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF LNI",
            "identifier": "0150495",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kitsap Physical Therapy and Sports Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.