Northwest Mobile Physical Therapy Specialists PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

NORTHWEST MOBILE PHYSICAL THERAPY SPECIALISTS PLLC

Practice address

119 W Columbia Ave
Spokane, WA 99205-6224

Phone

(509) 294-5579

NPI assigned

Apr 27, 2020

Organization subpart

No

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

Authorized official

Name

Charles Nichols IIINPI 1194346502

Title

Founder/PT

Phone

(509) 294-5579

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Nichols III

  • Geriatric Physical Therapist
  • Spokane, WA
  • NPI 1194346502
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1366063778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W COLUMBIA AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056224",
            "telephone_number": "509-294-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W COLUMBIA AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056224",
            "telephone_number": "509-294-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MOBILE PHYSICAL THERAPY SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "FOUNDER/PT",
        "authorized_official_telephone_number": "509-294-5579",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.