Individual provider Active NPI

Michael Kent McQuivey, PT

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1316928765
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00005278 Issued in WA
Practice address
9430 NE Vancouver Mall Dr
Vancouver, WA 98662-6172
Phone
(360) 256-9827
Fax
(360) 256-9547
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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 PT00005278 WA Primary

Addresses

Primary practice location

9430 NE Vancouver Mall Dr
Vancouver, WA 98662-6172

Mailing address

18612 NW 64TH Ave
Ridgefield, WA 98642-9616
Phone (360) 576-8831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT00005278WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Camas Physical Therapy Physical Therapist PastSince Oct 1, 2012 Accepting new patients
Northwest Rehabilitation Institute PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 2

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1316928765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18612 NW 64TH AVE",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986429616",
            "telephone_number": "360-576-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 NE VANCOUVER MALL DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626172",
            "telephone_number": "360-256-9827",
            "fax_number": "360-256-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUIVEY",
        "first_name": "MICHAEL",
        "middle_name": "KENT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00005278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.