Jet City Holdings, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

JET CITY HOLDINGS, INC

Doing business as

G2 Sports Therapy

Practice address

486 228TH Ave NE
Sammamish, WA 98074-7209

Phone

(425) 836-8444

Fax

(425) 836-8447

NPI assigned

Sep 25, 2012

Organization subpart

No

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

Authorized official

Name

Lance Randall Runje

Title

President

Phone

(425) 503-0830

Specialties & licenses 1

Addresses

Other names 1

• G2 Sports Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 7

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

• William J Fletcher, PT

  • Physical Therapist
  • Kirkland, WA
  • NPI 1154303766
  Medicare reassignment Care Compare group NPD
• Timothy O'Meara, DPT, PT

  • Physical Therapist
  • Bellevue, WA
  • NPI 1528896966
  Medicare reassignment Care Compare group NPD
• Samuel Lee Griffiths, DPT

  • Physical Therapist
  • Lone Pine, CA
  • NPI 1710580188

  WA

  Medicare reassignment Care Compare group NPD
• Robert J Bradbury, PT

  • Physical Therapist
  • Issaquah, WA
  • NPI 1205854643
  Medicare reassignment NPD
• Mariyam Merchant, M.P.T

  • Physical Therapist
  • Bellevue, WA
  • NPI 1972962512
  Medicare reassignment NPD
• John Wyatt Worrel, PT, DPT

  • Physical Therapist
  • Seattle, WA
  • NPI 1336648021
  Medicare reassignment NPD
• Zahra Anne Young, D.P.T.

  • Physical Therapist
  • Normandy Park, WA
  • NPI 1467639765
  Medicare reassignment NPD

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1396096731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1482 26TH AVE NE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297414",
            "telephone_number": "425-503-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 228TH AVE NE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980747209",
            "telephone_number": "425-836-8444",
            "fax_number": "425-836-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JET CITY HOLDINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "RUNJE",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-503-0830"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "G2 Sports Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Jarakji
• Chelsea Blake Jarett, RDH, OMT
• Julia Jarzembowski, #MA.60549262
• Jason Widner DMD, PS
• Damani Jefferson
• Mark Alan Jewett, MSW, CADC-II, CDP
• John M Rossi, DDS
• Sophie Lia John
• Brenda Charlene Johnson, LMP
• Jessica T Johnson, NURSE PRACTITIONER

• Physical Therapy Clinic/Center in Sammamish, WA
• Providers in Sammamish, 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 Sep 25, 2012; 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.