NPIMap

Organization Active NPI

Pro-Motion Physical Therapy and Functional Fitness P.C.

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1174740708
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
601-738-216 Issued in WA
Legal business name
PRO-MOTION PHYSICAL THERAPY AND FUNCTIONAL FITNESS P.C.
Practice address
2006 W Lincoln Ave Ste a
Yakima, WA 98902-2406
Phone
(509) 573-4816
Fax
(509) 573-4825
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Authorized official

Name
Mr. Michael D. Kane, MPT, MOMTNPI 1538128657
Title
Owner
Phone
(509) 573-4816

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 MULTIPLE SINGLE SPECIALTY GROUP 225100000X 601-738-216 WA Primary

Addresses

Primary practice location

2006 W Lincoln Ave Ste a
Yakima, WA 98902-2406

Mailing address

2006 W Lincoln Ave Ste a
Yakima, WA 98902-2406
Phone (509) 573-4816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090518000096 WA Part B Supplier - Clinic/Group Practice 2961551213 Receives reassigned benefits from 5 practitioners
Practice locations: Yakima, WA

National Provider Directory

National Provider Directory

Locations

2006 W Lincoln Ave
Ste A
Yakima, WA 98902
Phone (509) 573-4816

2006 W Lincoln Ave
#A
Yakima, WA 98902
Phone (509) 573-4816

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433462400000",
    "number": "1174740708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 W LINCOLN AVE STE A",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022406",
            "telephone_number": "509-573-4816",
            "fax_number": "509-573-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 W LINCOLN AVE STE A",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022406",
            "telephone_number": "509-573-4816",
            "fax_number": "509-573-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-MOTION PHYSICAL THERAPY AND FUNCTIONAL FITNESS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2015-06-05",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-573-4816",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT, MOMT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "601-738-216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.