Kitsap Physical Therapy and Sports Clinic PS Inc
Organization Active NPI Durable Medical Equipment & Medical Supplies · Bainbridge Island, WA
NPI 1154901437 · NPPES record last updated May 21, 2021
Key facts
- NPI
- 1154901437
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC
- Practice address
- 945 Hildebrand LN NE Ste 220
Bainbridge Island, WA 98110-2877 - Phone
- (206) 842-6288
- Fax
- (360) 598-3282
- NPI assigned
- Apr 12, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC
Authorized official
- Name
- Summer Zumwalt
- Title
- HRD
- Phone
- (360) 598-3764
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 3
Practitioners 143
-
Jarel Bakke, DPT
-
Jillian Barry, OT
-
Thayne Lyndon Bosh, DPT
-
Jennifer Rose Briant, DPT
-
Ryan Brinton, DPT
-
Rose K Christen, DPT
-
Jonathan Dyk, PT
-
Jennifer Edwards, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210623003148 | WA | DME Supplier - Independently-Practicing Physical Therapist |
6507762333 | Practice locations: Silverdale, WA |
National Provider Directory
- Tax ID family
- Kitsap PT and Sports Clinic
- Part of
- Kitsap PT and Sports Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
945 Hildebrand LN NE Ste 220
Bainbridge Island, WA 98110-2877
Mailing address
2400 NW Myhre Rd Ste 101
Silverdale, WA 98383-7672
Phone (360) 598-3764
Other providers in Bainbridge Island, WA
- Cresaya Emiliana Kingsbury
- Genevieve L Kinney
- Kirk, Sherris
- David Dean Kirscher
- Kitsap County Fire District No 2
- Kenneth Bruce Klein
- Thomas Michael Knight
- Mary-Beth Hannon Kobs
- Maria Kaya Kojima
- Evan Kostenko
All providers in Bainbridge Island, WA · Durable Medical Equipment & Medical Supplies in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.