Individual provider Active NPI

Kevin Norris

  • Physical Therapist
  • Bothell, WA
National Provider Identifier
1316348030
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60466591 Issued in WA
Practice address
17901 Bothell Everett Hwy Ste F-104
Bothell, WA 98012-6387
Phone
(425) 424-3924
Fax
(425) 424-3941
NPI assigned
Sep 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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 PT60466591 WA Primary

Addresses

Primary practice location

17901 Bothell Everett Hwy Ste F-104
Bothell, WA 98012-6387

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other identifiers 2

IdentifierTypeStateIssuer
2040088MedicaidWA
P01610738OtherWARR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141204000807 WA Practitioner - Physical Therapist in Private Practice 4981926805 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

17901 Everrett Hwy
Suite F104
Bothell, WA 98012
Phone (425) 424-3924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Oct 1, 2014 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Sep 11, 2014 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC CurrentSince Oct 1, 2014 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 1, 2014 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Oct 1, 2014 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Sep 11, 2014 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 1, 2014 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC Physical Therapist CurrentSince Oct 1, 2014 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

1300 W Sam Houston Pkwy S
Ste 300
Houston, TX 77042
Phone (713) 297-7052

2000 Hewitt Ave
Ste 115
Everett, WA 98201
Phone (425) 252-3908

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

18910 28th Ave W
Lynnwood, WA 98036
Phone (425) 775-5557

17901 Bothell Everett Hwy
Mill Creek, WA 98012
Phone (425) 424-3924

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

4250 Martin Way E
Ste 105
Olympia, WA 98516
Phone (360) 486-0640

5420 Barnes Ave NW
Seattle, WA 98107
Phone (206) 789-7975

1830 Bickford Ave
Ste 209
Snohomish, WA 98290
Phone (360) 568-7774

Interoperability endpoints

  • Direct secure messaging: kevin.norris.1@31414.direct.athenahealth.com

Organizations & group practices 11

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": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1316348030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 BOTHELL EVERETT HWY STE F-104",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980126387",
            "telephone_number": "425-424-3924",
            "fax_number": "425-424-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60466591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2040088",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01610738",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.