NPIMap

Organization Active NPI

Integrated Rehabilitation Group, PC

Doing business as IRG Physical & Hand Therapy - Marysville

  • Physical Therapy Clinic/Center
  • Marysville, WA
National Provider Identifier
1215201801
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
INTEGRATED REHABILITATION GROUP, PC
Doing business as
IRG Physical & Hand Therapy - Marysville
Marysville Physical Therapy
Practice address
919 State Ave
Suite 101
Marysville, WA 98270-4284
Phone
(360) 386-7405
Fax
(360) 386-7406
NPI assigned
Feb 29, 2012
Last updated
Dec 28, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRATED REHABILITATION GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Authorized official

Name
Michael Shannon Okelley, MPTNPI 1730142381
Title
President/Owner
Phone
(425) 316-8046

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

919 State Ave
Suite 101
Marysville, WA 98270-4284

Mailing address

4220 132ND St SE Ste 101
Mill Creek, WA 98012-8999
Phone (425) 357-9380

Other names 2

  • IRG Physical & Hand Therapy - Marysville Doing business as
  • Marysville Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251111001272 WA DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 0042111718 Practice locations: Marysville, WA

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Integrated Rehabilitati38 organizations share this tax ID, including this one
Part of
Integrated Rehabilitati

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

9411 192nd Ave E
Bldg D
Bonney Lake, WA 98391
Phone (253) 268-5105

722 E University Way
Ellensburg, WA 98926
Phone (509) 962-1533

1100 Pacific Ave
Ste 201
Everett, WA 98201
Phone (425) 374-2846

1515 Pacific Ave
Ste 201
Everett, WA 98201
Phone (425) 374-2846

2701 171st Pl NE
Ste 203
Marysville, WA 98271
Phone (360) 386-7401

275 SE Cabot Dr
Ste A5
Oak Harbor, WA 98277
Phone (360) 914-5504

22500 NE Marketplace Dr
Ste 204
Redmond, WA 98053
Phone (425) 836-1034

22500 NE Marketplace Dr
Ste Cd
Redmond, WA 98053
Phone (425) 836-1034

Practitioners & affiliated clinicians

Practitioners 381

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.

View all 381

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1215201801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 132ND ST SE STE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980128999",
            "telephone_number": "425-357-9380",
            "fax_number": "425-357-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 STATE AVE",
            "address_2": "SUITE 101",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704284",
            "telephone_number": "360-386-7405",
            "fax_number": "360-386-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHABILITATION GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED REHABILITATION GROUP, PC",
        "enumeration_date": "2012-02-29",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "OKELLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "425-316-8046",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IRG Physical & Hand Therapy - Marysville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marysville Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marysville Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.