NPIMap

Organization Active NPI

Chewelah Orthopedic & Sports Physical Therapy Inc.

  • Physical Therapist
  • Chewelah, WA
National Provider Identifier
1235353368
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0123911 Issued in WA
Legal business name
CHEWELAH ORTHOPEDIC & SPORTS PHYSICAL THERAPY INC.
Practice address
N 119 3Rd St E
Chewelah, WA 99109
Phone
(509) 935-4988
Fax
(509) 935-4985
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Robert R Brewer, P.T., M.O.M.T.
Title
Owner
Phone
(509) 935-4988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 0123911 WA Primary

Addresses

Primary practice location

N 119 3Rd St E
Chewelah, WA 99109

Mailing address

PO Box 909
Chewelah, WA 99109-0909
Phone (509) 935-4988

Other identifiers 2

IdentifierTypeStateIssuer
7091564MedicaidWA
8446924MedicaidWA

National Provider Directory

National Provider Directory

Locations

101 N Park St
Chewelah, WA 99109
Phone (509) 935-4988

143 Garden Homes Dr
Colville, WA 99114
Phone (509) 684-3701

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1235353368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991090909",
            "telephone_number": "509-935-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N 119 3RD ST E",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "99109",
            "telephone_number": "509-935-4988",
            "fax_number": "509-935-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEWELAH ORTHOPEDIC & SPORTS PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-935-4988",
        "authorized_official_credential": "P.T., M.O.M.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "0123911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7091564",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8446924",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chewelah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.