Randy A Notebloom, PT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT00003291 Issued in WA

Practice address

904 7TH Ave
Seattle, WA 98104-1132

Phone

(206) 223-6487

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: randy.noteboom@direct.vmmc.org

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1407993553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 OLIVE WAY MSC M4-PA",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011873",
            "telephone_number": "206-515-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-223-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTEBLOOM",
        "first_name": "RANDY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WA",
            "license": "PT00003291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "NO5497",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US1051973",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES #",
            "identifier": "0039585",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8342677",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00079877",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nosh & Nurture PLLC
• Clarence Nosimbang
• Katherine Noson, LMHCA
• Erika H. Noss, M.D., PH.D.
• Eliza Notaro, M.D.
• Klay Rose Noto, MD
• Elisha Nottingham, OTR
• Sarah Nottingham, LMP
• Jamie K Notzka, PAC
• Krista Noulles

• Sports Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Sports Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.