Individual provider Active NPI

Diana Lynn Smith, PHYSICAL THERAPIST

  • Physical Therapist
  • Liberty Lake, WA
National Provider Identifier
1275549891
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007834 Issued in WA
Practice address
23327 East Appleway
Ste 160
Liberty Lake, WA 99019-5038
Phone
(509) 891-2258
Fax
(509) 891-2094
NPI assigned
Aug 1, 2006
Last updated
Nov 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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 PT00007834 WA Primary

Addresses

Primary practice location

23327 East Appleway
Ste 160
Liberty Lake, WA 99019-5038

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1275549891MedicaidWA

Other names 1

  • Miss Diana Lynn Keast Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060918000050 WA Practitioner - Physical Therapist in Private Practice 8921003492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Rehabilitation Associates, PLLCGroup PAC ID 8325937642, 33 clinicians

Practice addresses (Care Compare)

407 E 2ND Ave
Suite 100
Spokane, WA 99202-1428
Phone (509) 455-6002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00007834WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Rehabilitation Associates, PLLC Physical Therapist CurrentSince Aug 17, 2013 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Advanced Physical Therapy Inc Physical Therapist Past Accepting new patients
Lake City Physical Therapy P a Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Summit Rehab Valley Corporation Physical Therapist PastSince Aug 17, 2013 Accepting new patients

Locations

407 E 2nd Ave
Ste 100
Spokane, WA 99202
Phone (509) 455-6002

9911 N Nevada St
Ste A
Spokane, WA 99218
Phone (509) 327-1578

Organizations & group practices 6

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1275549891",
    "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": "23327 EAST APPLEWAY",
            "address_2": "STE 160",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195038",
            "telephone_number": "509-891-2258",
            "fax_number": "509-891-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIANA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275549891",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "KEAST",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "PHYSICAL THERAPIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.