NPIMap

Organization Active NPI

Complete Therapy Services, PLLC

  • Physical Therapist
  • Sunnyside, WA
National Provider Identifier
1225175474
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007057 Issued in WA
Legal business name
COMPLETE THERAPY SERVICES, PLLC
Practice address
716 E Edison Ave
Sunnyside, WA 98944-2204
Phone
(509) 837-4455
Fax
(509) 837-6299
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Authorized official

Name
Mr. Victor Charles Withers Jr., O.T.R./LNPI 1023086923
Title
Owner
Phone
(509) 837-4455

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT00007057 WA Primary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X MA00017106 WA
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X OT00003196 WA

Addresses

Primary practice location

716 E Edison Ave
Sunnyside, WA 98944-2204

Mailing address

716 E Edison Ave
Sunnyside, WA 98944-2204
Phone (509) 837-4455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000907 WA Part B Supplier - Clinic/Group Practice 8820986649 Receives reassigned benefits from 2 practitioners
Practice locations: Grandview, WA; Sunnyside, WA

National Provider Directory

National Provider Directory

Locations

100 E 3rd St
Grandview, WA 98930
Phone (509) 203-6601

716 E Edison Ave
Sunnyside, WA 98944
Phone (509) 837-4455

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1225175474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 E EDISON AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442204",
            "telephone_number": "509-837-4455",
            "fax_number": "509-837-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E EDISON AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442204",
            "telephone_number": "509-837-4455",
            "fax_number": "509-837-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE THERAPY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "WITHERS",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-837-4455",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.T.R./L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007057",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00017106",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00003196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.