NPIMap

Organization Active NPI

Integrated Rehabilitation Group, PC

Doing business as South Sound Physical & Hand Therapy - Market Place

  • Physical Therapy Clinic/Center
  • Olympia, WA
National Provider Identifier
1275727265
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
INTEGRATED REHABILITATION GROUP, PC
Doing business as
South Sound Physical & Hand Therapy - Market Place
Practice address
111 Market St NE Ste 108
Olympia, WA 98501-1008
Phone
(360) 754-7085
Fax
(360) 754-3671
NPI assigned
Sep 1, 2007
Last updated
Apr 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRATED REHABILITATION GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Michael S OkelleyNPI 1730142381
Title
Owner
Phone
(425) 316-8046

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

111 Market St NE Ste 108
Olympia, WA 98501-1008

Mailing address

4220 132ND St SE
Suite 101
Mill Creek, WA 98012-8999
Phone (425) 357-9380

Other names 2

  • South Sound Physical & Hand Therapy - Market Place Doing business as
  • South Sound Physical & Hand Therapy, PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000944 WA Part B Supplier - Clinic/Group Practice 0042111718 Receives reassigned benefits from 350 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sammamish, WA; Mount Vernon, WA; Puyallup, WA; Olympia, WA; Oak Harbor, WA; Mukilteo, WA; Mountlake Terrace, WA; Seattle, WA…

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Part of
Integrated Rehabilitation Group Inc

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

16030 Bothell Hwy
Ste 140
Mill Creek, WA 98012
Phone (425) 338-9005

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1188604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1275727265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 132ND ST SE",
            "address_2": "SUITE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980128999",
            "telephone_number": "425-357-9380",
            "fax_number": "425-357-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARKET ST NE STE 108",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011008",
            "telephone_number": "360-754-7085",
            "fax_number": "360-754-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHABILITATION GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED REHABILITATION GROUP, PC",
        "enumeration_date": "2007-09-01",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "OKELLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-316-8046"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Sound Physical & Hand Therapy - Market Place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Sound Physical & Hand Therapy, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "South Sound Physical & Hand Therapy, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.