Individual provider Active NPI

Douglas W Free

  • Physical Therapist
  • Mercer Island, WA
National Provider Identifier
1225055767
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008195 Issued in WA
Practice address
7900 SE 28TH
#102
Mercer Island, WA 98040-6005
Phone
(206) 232-9045
Fax
(206) 232-8871
NPI assigned
Jul 17, 2006
Last updated
Jul 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00008195 WA Primary

Addresses

Primary practice location

7900 SE 28TH
#102
Mercer Island, WA 98040-6005

Mailing address

11711 NE 12TH St
#3A
Bellevue, WA 98005-2461
Phone (425) 450-9474

Other identifiers 1

IdentifierTypeStateIssuer
7060312MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907000258 WA Practitioner - Physical Therapist in Private Practice 3476677956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Management Services PLLCGroup PAC ID 0143500983, 107 clinicians

Practice addresses (Care Compare)

275 SW 160TH St
Suite 105
Burien, WA 98166-3003
Phone (206) 513-2155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00008195WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Management Services, PLLC Physical Therapist CurrentSince Jun 2, 2022 Accepting new patients
Therapy Management Services, PLLC Physical Therapist CurrentSince Jun 2, 2022 Accepting new patients
Therapy Management Services, PLLC Physical Therapist Current Accepting new patients
Therapy Management Services, PLLC Physical Therapist Past Accepting new patients

Locations

11711 NE 12th St
Ste 3A
Bellevue, WA 98005
Phone (425) 454-1405

915 118th Ave SE
Ste 110
Bellevue, WA 98005
Phone (425) 243-6922

814 DuPont St
Bellingham, WA 98225
Phone (360) 671-2900

15500 1st Ave S
Ste 106
Burien, WA 98148
Phone (206) 242-0855

275 SW 160th St
Ste 105
Burien, WA 98166
Phone (206) 244-4263

12910 Totem Lake Blvd NE
Ste 105
Kirkland, WA 98034
Phone (425) 823-8631

19217 36th Ave W
Ste 102
Lynnwood, WA 98036
Phone (425) 670-9991

7900 SE 28th St
Ste 102
Mercer Island, WA 98040
Phone (206) 232-9045

709 Cook Rd
Sedro Woolley, WA 98284
Phone (360) 873-8191

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1225055767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 NE 12TH ST",
            "address_2": "#3A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052461",
            "telephone_number": "425-450-9474",
            "fax_number": "425-635-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 SE 28TH",
            "address_2": "#102",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980406005",
            "telephone_number": "206-232-9045",
            "fax_number": "206-232-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREE",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7060312",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.