Individual provider Active NPI

Jared Kent Hodgson, PT

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1235403064
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60264049 Issued in WA
Practice address
907 S Auburn St
Kennewick, WA 99336-5662
Phone
(509) 582-0429
Fax
(509) 582-1182
NPI assigned
Feb 24, 2012
Last updated
Feb 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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 PT60264049 WA Primary

Addresses

Primary practice location

907 S Auburn St
Kennewick, WA 99336-5662

Mailing address

7201 W Clearwater Ave
Suite B101
Kennewick, WA 99336-1694
Phone (509) 544-0265

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120724000859 OR Practitioner - Physical Therapist in Private Practice 3173785722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Physical Therapy Inc PSGroup PAC ID 6305747643, 44 clinicians

Practice addresses (Care Compare)

1020 S Main St
Milton Freewater, OR 97862-1534
Phone (541) 938-2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1235403064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 W CLEARWATER AVE",
            "address_2": "SUITE B101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361694",
            "telephone_number": "509-544-0265",
            "fax_number": "509-987-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 S AUBURN ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365662",
            "telephone_number": "509-582-0429",
            "fax_number": "509-582-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGSON",
        "first_name": "JARED",
        "middle_name": "KENT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60264049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.