NPIMap

Organization Active NPI

Therapeutic Associates Inc

Doing business as TAI - Southridge

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1437428810
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
THERAPEUTIC ASSOCIATES INC
Doing business as
TAI - Southridge
Practice address
4303 W 27TH Ave
Suite C
Kennewick, WA 99338-1986
Phone
(800) 219-8835
Fax
(203) 241-0028
NPI assigned
Dec 14, 2011
Last updated
May 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Todd Gifford, PTNPI 1770933061
Title
Coo
Phone
(800) 219-8835

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

4303 W 27TH Ave
Suite C
Kennewick, WA 99338-1986

Mailing address

16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other identifiers 1

IdentifierTypeStateIssuer
1437428810MedicaidWA

Other names 1

  • TAI - Southridge Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000117 WA Part B Supplier - Clinic/Group Practice 0042116279 Receives reassigned benefits from 127 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA; Selah, WA; Shoreline, WA; Spokane, WA; Liberty Lake, WA; Spokane Valley, WA; Tacoma, WA; University Place, WA…

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory
Tax ID family
Central Physical Therap100 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1437428810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 W 27TH AVE",
            "address_2": "SUITE C",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381986",
            "telephone_number": "800-219-8835",
            "fax_number": "203-241-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "GIFFORD",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-219-8835",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437428810",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAI - Southridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TAI - Southridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.