Individual provider Active NPI

Kara Lyn Stadshaug, DPT

  • Physical Therapist
  • Poulsbo, WA
National Provider Identifier
1306278106
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 60393310 Issued in WA
Practice address
19319 7TH Ave NE Ste 108
Poulsbo, WA 98370-7442
Phone
(360) 598-3764
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60393310 WA
Physical Therapist 225100000X PT 60393310 WA Primary

Addresses

Primary practice location

19319 7TH Ave NE Ste 108
Poulsbo, WA 98370-7442

Mailing address

19319 7TH Ave NE Ste 108
Poulsbo, WA 98370-7442
Phone (360) 598-3764

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130918000467 WA Practitioner - Physical Therapist in Private Practice 8022252865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kitsap Physical Therapy and Sports Clinic PS IncGroup PAC ID 6507762333, 142 clinicians

Practice addresses (Care Compare)

19505 7TH Ave NE
Poulsbo, WA 98370-7700
Phone (360) 779-3777

2400 NW Myhre Rd
Silverdale, WA 98383-7672
Phone (360) 613-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 60393310WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Aug 12, 2013 Accepting new patients
Port Gamble S'Klallam Tribe CurrentSince Nov 2, 2022 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Aug 12, 2013 Accepting new patients
Port Gamble S'Klallam Tribe CurrentSince Nov 2, 2022 Accepting new patients

Locations

32020 Little Boston Rd NE
Kingston, WA 98346
Phone (360) 297-2840

19319 7th Ave NE
Ste 108
Poulsbo, WA 98370
Phone (360) 598-3764

19319 7th Ave NE
Ste 100
Poulsbo, WA 98370
Phone (360) 297-7050

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

Organizations & group practices 4

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": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1306278106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19319 7TH AVE NE STE 108",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707442",
            "telephone_number": "360-598-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19319 7TH AVE NE STE 108",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707442",
            "telephone_number": "360-598-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADSHAUG",
        "first_name": "KARA",
        "middle_name": "LYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60393310",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 60393310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.