Individual provider Active NPI

Laurie Elizabeth Graves, PT, DPT

  • Physical Therapist
  • Longview, WA
National Provider Identifier
1306538434
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH11353 Issued in AL
Practice address
1560 3Rd Ave
Longview, WA 98632-3229
Phone
(360) 423-9535
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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 PTH11353 AL Primary

Addresses

Primary practice location

1560 3Rd Ave
Longview, WA 98632-3229

Mailing address

929 King Drake Rd
Brownsboro, AL 35741-9573
Phone (256) 337-7962

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230707001984 WA Practitioner - Physical Therapist in Private Practice 7618336710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
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)

2500 Cherry Ave
Bremerton, WA 98310-4202
Phone (360) 792-1015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH11353ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jan 12, 2024 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jan 12, 2024 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Physical Therapist CurrentSince Jun 21, 2023 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Peak Sports & Spine Physical Therapy-Klahanie PS Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2500 Cherry Ave
Bremerton, WA 98310
Phone (360) 620-3847

1714 S Gold St
Centralia, WA 98531
Phone (360) 360-5532

4411 Point Fosdick Dr
Ste 101
Gig Harbor, WA 98335
Phone (253) 851-7472

1560 3rd Ave
Longview, WA 98632
Phone (360) 423-9535

4550 Klahanie Dr SE
Sammamish, WA 98029
Phone (425) 391-2427

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

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1306538434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 KING DRAKE RD",
            "city": "BROWNSBORO",
            "state": "AL",
            "postal_code": "357419573",
            "telephone_number": "256-337-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 3RD AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323229",
            "telephone_number": "360-423-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "LAURIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH11353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.