Individual provider Active NPI

Kimberly Ann Cole, MSPT

  • Physical Therapist
  • College Place, WA
National Provider Identifier
1336237155
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006939 Issued in WA
Practice address
716 S College Ave
College Place, WA 99324-1519
Phone
(509) 540-2862
Fax
(509) 527-8838
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3061 OR
Physical Therapist 225100000X PT00006939 WA Primary

Addresses

Primary practice location

716 S College Ave
College Place, WA 99324-1519

Mailing address

708 SE 4TH St
College Place, WA 99324-1319
Phone (509) 540-2862

Other practice location 1

55 W Tietan St
Walla Walla, WA 99362-4445
Phone (509) 525-3720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060220000491 OR Practitioner - Physical Therapist in Private Practice 9931114469 Reassigns benefits to 1 organization
I20161128002349 WA Practitioner - Physical Therapist in Private Practice 9931114469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tier 1 Therapy LLC 5 clinicians

Practice addresses (Care Compare)

1500 Catherine St
Apt Ofc
Walla Walla, WA 99362-4181
Phone (509) 987-4316

540 NW 12TH St
Hermiston, OR 97838-9001
Phone (509) 551-8156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3061ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Oregon Physical Therapy, LLC Physical Therapist CurrentSince Sep 8, 2019 Accepting new patients
Tier 1 Therapy LLC Physical Therapist CurrentSince Apr 23, 2022 Accepting new patients
Therapy Options LLC PastSince Apr 23, 2022 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Physical Therapist PastSince Feb 24, 2020 Accepting new patients

Locations

301 4th St
La Grande, OR 97850
Phone (541) 963-9340

245 Van Giesen St
Bldg C
Richland, WA 99354
Phone (503) 302-1459

Organizations & group practices 4

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1336237155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 SE 4TH ST",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241319",
            "telephone_number": "509-540-2862",
            "fax_number": "509-527-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 S COLLEGE AVE",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241519",
            "telephone_number": "509-540-2862",
            "fax_number": "509-527-8838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 W Tietan St",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993624445",
            "country_code": "US",
            "telephone_number": "509-525-3720",
            "fax_number": "509-522-1593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3061",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.