NPIMap

Organization Active NPI

Physical Rehabilitation & Wellness Center, PLLC

  • Non-Pharmacy Dispensing Site
  • Everett, WA
National Provider Identifier
1316287402
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
PHYSICAL REHABILITATION & WELLNESS CENTER, PLLC
Practice address
919 128TH St SW
Everett, WA 98204-6315
Phone
(310) 474-9809
NPI assigned
Feb 26, 2013
Organization subpart
Yes
Parent organization
PHYSICAL REHABILITATION & WELLNESS CENTER, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Authorized official

Name
Dr. Mohammad Shegeft, ND
Title
Medical Director
Phone
(310) 474-9809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

919 128TH St SW
Everett, WA 98204-6315

Mailing address

2980 N Beverly Glen Cir
Suite 100
Los Angeles, CA 90077-1726
Phone (310) 474-9809

National Provider Directory

National Provider Directory
Tax ID family
Puget Park Chiropractic Clinic PLLC2 organizations share this tax ID, including this one
Part of
Puget Park Chiropractic Clinic PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1316287402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809",
            "fax_number": "888-431-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 128TH ST SW",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982046315",
            "telephone_number": "310-474-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL REHABILITATION & WELLNESS CENTER, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICAL REHABILITATION & WELLNESS CENTER, PLLC",
        "enumeration_date": "2013-02-26",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "SHEGEFT",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-474-9809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.