Individual provider Active NPI

Joseph Earl Mackay, PHYSICAL THERAPIST

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1265521983
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010246 Issued in WA
Practice address
1408 N Louisiana St
Suite 104 a
Kennewick, WA 99336-7167
Phone
(509) 783-1962
Fax
(509) 783-1706
NPI assigned
Oct 12, 2006
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00010246 WA Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

1408 N Louisiana St
Suite 104 a
Kennewick, WA 99336-7167

Mailing address

11481 SW Hall Blvd
Ste 201
Portland, OR 97223-8403
Phone (800) 219-8835

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061117000214 WA Practitioner - Physical Therapist in Private Practice 8123026663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lourdes Hospital LLCGroup PAC ID 1850642562, shared by 5 NPIs, 42 clinicians

Practice addresses (Care Compare)

520 N 4TH Ave
Pasco, WA 99301-5257
Phone (509) 544-6176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00010246WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Hospital LLC CurrentSince Sep 1, 2018 Accepting new patients
Lourdes Hospital LLC Current Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Lourdes Hospital LLC Past Accepting new patients
Our Lady of Lourdes Hospital at Pasco Past Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

1200 N 14th Ave
Pasco, WA 99301
Phone (509) 547-7536

507 N 5th Ave
Pasco, WA 99301
Phone (509) 543-1975

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

7425 Wrigley Dr
Ste 204
Pasco, WA 99301
Phone (509) 416-0027

1175 Carondelet Dr
Richland, WA 99354
Phone (509) 943-9104

Organizations & group practices 7

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1265521983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11481 SW HALL BLVD",
            "address_2": "STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238403",
            "telephone_number": "800-219-8835",
            "fax_number": "503-443-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 N LOUISIANA ST",
            "address_2": "SUITE 104 A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367167",
            "telephone_number": "509-783-1962",
            "fax_number": "509-783-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAY",
        "first_name": "JOSEPH",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010246",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 8, 2007; 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.