NPIMap

Organization Active NPI

Integrated Rehabilitation Group Inc

Doing business as Redmond Ridge Physical & Hand Therapy

  • Physical Therapy Clinic/Center
  • Redmond, WA
National Provider Identifier
1316971377
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
INTEGRATED REHABILITATION GROUP INC
Doing business as
Redmond Ridge Physical & Hand Therapy
Practice address
22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033
Phone
(425) 836-1034
Fax
(425) 836-1037
NPI assigned
Jul 10, 2006
Last updated
Oct 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Michael Shannon O'Kelley, MPTNPI 1730142381
Title
Owner/Physical Therapist
Phone
(425) 337-9556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X WA
Hand Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225XH1200X WA
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033

Mailing address

1519 132ND St SE
Suite a
Everett, WA 98208-7203
Phone (425) 330-0633

Other names 1

  • Redmond Ridge Physical & Hand Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000944 WA Part B Supplier - Clinic/Group Practice 0042111718 Receives reassigned benefits from 350 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sammamish, WA; Mount Vernon, WA; Puyallup, WA; Olympia, WA; Oak Harbor, WA; Mukilteo, WA; Mountlake Terrace, WA; Seattle, WA…

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1316971377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 132ND ST SE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982087203",
            "telephone_number": "425-330-0633",
            "fax_number": "425-338-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22500 NE MARKETPLACE DR",
            "address_2": "SUITE 204",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980532033",
            "telephone_number": "425-836-1034",
            "fax_number": "425-836-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHABILITATION GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "O'KELLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "425-337-9556",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redmond Ridge Physical & Hand Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.