Epic PT Health & Performance LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

603331038 Issued in WA

Legal business name

EPIC PT HEALTH & PERFORMANCE LLC

Doing business as

Epic Physical Therapy

Practice address

5006 Center St Ste N
Tacoma, WA 98409-2314

Phone

(253) 476-3333

Fax

(253) 476-3334

NPI assigned

Sep 18, 2013

Last updated

Jul 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dan Ahdut

Title

Manager

Phone

(253) 223-1594

Specialties & licenses 1

Addresses

Other names 1

• Epic Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 35

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.

• Norman Fabula, PT

  • Physical Therapist
  • Port Orchard, WA
  • NPI 1841491149
  Medicare reassignment Care Compare group NPD
• Jonathan P. Jove, MPT

  • Physical Therapist
  • Olympia, WA
  • NPI 1023153392
  Medicare reassignment Care Compare group NPD
• Jesse Ryan Pooler, M.P.T.

  • Physical Therapist
  • Tacoma, WA
  • NPI 1003020520
  Medicare reassignment Care Compare group NPD (past)
• Kristina Bondar, DPT

  • Physical Therapist
  • Sumner, WA
  • NPI 1851155709
  Medicare reassignment NPD
• Heidi Kodeski, PT

  • Physical Therapist
  • Bellevue, WA
  • NPI 1225102700
  Medicare reassignment NPD
• Rima Shah

  • Physical Therapist
  • Issaquah, WA
  • NPI 1780019349
  Medicare reassignment NPD
• Sophie Warshaw, DPT

  • Physical Therapist
  • Puyallup, WA
  • NPI 1134637176
  Medicare reassignment NPD
• Angelito Ancheta Mabini, MSPT

  • Physical Therapist
  • University Place, WA
  • NPI 1083880561
  Medicare reassignment
• Chingwen Chuang, DPT

  • Physical Therapist
  • Bellevue, WA
  • NPI 1356133169
  NPD
• Charene Eshaun Gonzales, LMT

  • Massage Therapist
  • Kent, WA
  • NPI 1992505937
  NPD
• Robert Michael Johnston, LMT

  • Massage Therapist
  • Bellevue, WA
  • NPI 1437842242
  NPD
• Jiajing Lin, DPT

  • Physical Therapist
  • Federal Way, WA
  • NPI 1144012055
  NPD

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1407282734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 CENTER ST STE N",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984092314",
            "telephone_number": "253-476-3333",
            "fax_number": "253-476-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 CENTER ST STE N",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984092314",
            "telephone_number": "253-476-3333",
            "fax_number": "253-476-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC PT HEALTH & PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-18",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "AHDUT",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "253-223-1594",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "603331038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Epic Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ayron Enriquez
• Raina M Ensign
• Michael Jon Enstad, D.C.
• Envision Home Health of Washington LLC (Envision Healthcare at Home)
• Ariana Omid Enzerink, DO
• Rosa F Epistola
• Amee Jo Epler, PH.D.
• Romi Epstein, L.AC.
• Joseph Ercanbrack
• Christopher Paul Erdman, M.D.

• Physical Therapist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.