Athletic Potential Performance Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ATHLETIC POTENTIAL PERFORMANCE PHYSICAL THERAPY LLC

Practice address

23211 66TH Ave S
Kent, WA 98032

Phone

(636) 208-7866

NPI assigned

May 23, 2024

Organization subpart

No

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

Authorized official

Name

Dylan Newcomer, PT, DPTNPI 1447985601

Title

Owner, Physical Therapist

Phone

(636) 208-7866

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Dylan Newcomer, DR.

  • Sports Physical Therapist
  • Kent, WA
  • NPI 1447985601
  NPD Authorized official

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1194564658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23211 66TH AVE S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "98032",
            "telephone_number": "636-208-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23211 66TH AVE S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "98032",
            "telephone_number": "636-208-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC POTENTIAL PERFORMANCE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "NEWCOMER",
        "authorized_official_first_name": "DYLAN",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "636-208-7866",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Kent, WA
• Providers in Kent, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.