Liberty Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

00002906 Issued in WA

Legal business name

LIBERTY PHYSICAL THERAPY

Practice address

1820 12TH Ave
Suite 101
Seattle, WA 98122-2438

Phone

(206) 860-3746

NPI assigned

Dec 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kim Bennett, PT PHD

Title

Physical Therapist/Owner Manager

Phone

(206) 778-6405

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Domenic Visocchi, MSPT

  • Orthopedic Physical Therapist
  • Medford, MA
  • NPI 1639183445
  NPD (past)

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1265701395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 SE 45TH ST",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980404144",
            "telephone_number": "206-778-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 12TH AVE",
            "address_2": "SUITE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222438",
            "telephone_number": "206-860-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER MANAGER",
        "authorized_official_telephone_number": "206-778-6405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT PHD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "00002906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zi Wei Liao, MD
• Gene S. J. Liaw, M.D.
• Clara Elisabeth Helene Libbrecht, MD, PHD
• Liberated Heart Counseling PLLC
• Justin Scott Liberman, MD
• Ryan D Liberty, ARNP
• William Mercurio Libetario Jr., CRNA
• Heather Libman, BA
• Jamie Libman, M.D.
• Taylor Michelle Libman

• Physical Therapy Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.