Individual provider Active NPI

Marlene T Vanwingerden, PT

  • Physical Therapist
  • Sunnyside, WA
National Provider Identifier
1285666370
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009274 Issued in WA
Practice address
1405 E Edison Ave
Sunnyside, WA 98944-1622
Phone
(509) 837-7400
Fax
(509) 837-5068
NPI assigned
Jul 7, 2006
Last updated
Dec 6, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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 PT00009274 WA Primary

Addresses

Primary practice location

1405 E Edison Ave
Sunnyside, WA 98944-1622

Mailing address

PO Box 307
Bountiful, UT 84011-0307
Phone (801) 294-6907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061211000234 WA Practitioner - Physical Therapist in Private Practice 1254330723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

513 1St Ave
Zillah, WA 98953-9432
Phone (509) 829-5230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00009274WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyside Physical & Sports Therapy Physical Therapist CurrentSince Oct 1, 2007 Accepting new patients
Peak Physical Therapy P C Physical Therapist PastSince Feb 1, 2023 Accepting new patients
Sunnyside Community Hospital Association PastSince Oct 1, 2007 Accepting new patients
Washington Physical Therapy PLLC PastSince Dec 1, 2006 Accepting new patients

Locations

1405 E Edison Ave
Sunnyside, WA 98944
Phone (509) 837-1375

Organizations & group practices 5

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1285666370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 E EDISON AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989441622",
            "telephone_number": "509-837-7400",
            "fax_number": "509-837-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWINGERDEN",
        "first_name": "MARLENE",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.