Individual provider Active NPI

Rebekah Muir, PTA

  • Physical Therapy Assistant
  • College Place, WA
National Provider Identifier
1366909517
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P260936336 Issued in WA
Practice address
420 SE Myra Rd
College Place, WA 99324-1796
Phone
(509) 529-4480
NPI assigned
Feb 25, 2019
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8596707-2402 UT
Physical Therapy Assistant 225200000X P260936336 WA Primary

Addresses

Primary practice location

420 SE Myra Rd
College Place, WA 99324-1796

Mailing address

1233 SW Carver St
College Place, WA 99324-1269

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

State licenses

LicenseStateTypeSpecialty
8596707-2402UTMDPhysical Therapy Assistant
P260936336WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1366909517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 SW CARVER ST",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SE MYRA RD",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241796",
            "telephone_number": "509-529-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUIR",
        "first_name": "REBEKAH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "UT",
            "license": "8596707-2402",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P260936336",
            "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 Mar 5, 2019; 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.