NPIMap

Individual provider Active NPI

Kirstin Uchida, PT

  • Physical Therapist
  • Maple Valley, WA
National Provider Identifier
1275685372
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008687 Issued in WA
Practice address
23925 225TH Way SE
Suite B
Maple Valley, WA 98038-5233
Phone
(425) 433-0123
Fax
(425) 433-0733
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 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 PT00008687 WA Primary

Addresses

Primary practice location

23925 225TH Way SE
Suite B
Maple Valley, WA 98038-5233

Mailing address

23925 225TH Way SE
Suite B
Maple Valley, WA 98038-5233
Phone (425) 433-0123

Other names 1

  • Kirstin Petersen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8356NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Suresteps Inc PastSince Aug 1, 2009 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1275685372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23925 225TH WAY SE",
            "address_2": "SUITE B",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385233",
            "telephone_number": "425-433-0123",
            "fax_number": "425-433-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23925 225TH WAY SE",
            "address_2": "SUITE B",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385233",
            "telephone_number": "425-433-0123",
            "fax_number": "425-433-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UCHIDA",
        "first_name": "KIRSTIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTIN",
            "last_name": "PETERSEN",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Maple Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.