Podium Physical Therapy & Performance Training PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PODIUM PHYSICAL THERAPY & PERFORMANCE TRAINING PLLC

Practice address

6708 NE College Parkway
Moses Lake, WA 98837

Phone

(509) 707-8085

NPI assigned

Mar 8, 2021

Organization subpart

No

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

Authorized official

Name

Ryan Carpenter, PT, DPT

Title

Owner

Phone

(509) 707-8085

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1417542820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9324 ALBERT WAY SE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988379053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6708 NE COLLEGE PARKWAY",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "98837",
            "telephone_number": "509-707-8085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9324 Albert Way SE",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988379053",
            "country_code": "US",
            "telephone_number": "509-707-8085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PODIUM PHYSICAL THERAPY & PERFORMANCE TRAINING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-707-8085",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ryan@podiumpt.com",
            "affiliation": "N",
            "address_1": "6708 NE College Parkway",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.