Individual provider Active NPI

Jonathan Burrup, PT

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1437635497
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62874 Issued in OR
Practice address
35 S Louisiana St Ste A140
Kennewick, WA 99336-8632
Phone
(509) 582-0429
Fax
(509) 582-1182
NPI assigned
Jul 12, 2018
Last updated
Jul 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 62874 OR Primary

Addresses

Primary practice location

35 S Louisiana St Ste A140
Kennewick, WA 99336-8632

Mailing address

7201 W Clearwater Ave Ste B101
Kennewick, WA 99336-1694
Phone (509) 544-0265

Other identifiers 1

IdentifierTypeStateIssuer
62874OtherOROREGON PHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180925000603 WA Practitioner - Physical Therapist in Private Practice 5395094262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Physical Therapy Inc PSGroup PAC ID 6305747643, 44 clinicians

Practice addresses (Care Compare)

343 Wellsian Way
Richland, WA 99352-4107
Phone (509) 946-9191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1437635497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 W CLEARWATER AVE STE B101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361694",
            "telephone_number": "509-544-0265",
            "fax_number": "509-987-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S LOUISIANA ST STE A140",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368632",
            "telephone_number": "509-582-0429",
            "fax_number": "509-582-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUP",
        "first_name": "JONATHAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON PHYSICAL THERAPY LICENSE",
            "identifier": "62874",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.