Individual provider Active NPI

Clifford Byron Ross II

  • Physical Therapy Assistant
  • Mount Vernon, WA
National Provider Identifier
1437528338
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160570116 Issued in WA
Practice address
2116 E Section St Ste B
Mount Vernon, WA 98274-9124
Phone
(360) 873-8356
Fax
(360) 899-4641
NPI assigned
Sep 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160570116 WA Primary

Addresses

Primary practice location

2116 E Section St Ste B
Mount Vernon, WA 98274-9124

Mailing address

PO Box 505
La Conner, WA 98257-0505
Phone (360) 873-8356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P160570116WAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Point Physical Therapy Clinic LTD. PastSince Apr 20, 2015 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1437528338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982570505",
            "telephone_number": "360-873-8356",
            "fax_number": "360-899-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 E SECTION ST STE B",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982749124",
            "telephone_number": "360-873-8356",
            "fax_number": "360-899-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CLIFFORD",
        "middle_name": "BYRON",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160570116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.