Back to Basics Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BACK TO BASICS PHYSICAL THERAPY, PLLC

Practice address

8033 W Grandridge Blvd Ste a
Kennewick, WA 99336-7159

Phone

(509) 783-2225

Fax

(509) 783-1898

NPI assigned

Dec 7, 2021

Organization subpart

No

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

Authorized official

Name

Kellee P Orr, PT

Title

Owner

Phone

(509) 783-2225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Kellee P Rettig, PT

  • Physical Therapist
  • Kennewick, WA
  • NPI 1467851360
  Medicare reassignment NPD

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1225796188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8033 W GRANDRIDGE BLVD STE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367159",
            "telephone_number": "509-783-2225",
            "fax_number": "509-783-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8033 W GRANDRIDGE BLVD STE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367159",
            "telephone_number": "509-783-2225",
            "fax_number": "509-783-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO BASICS PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "ORR",
        "authorized_official_first_name": "KELLEE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-783-2225",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Azzopardi, MASSAGE PRACTITIONER
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• Brenda L Baalman, OT
• Carsen Bach, CBT
• Miranda Bachman, LMP
• Back to Life LLC - Ben Booher DO
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• Belinda Michelle Badorek, OD
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• Bret A. Bailey, D.C.

• Physical Therapist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.