Jennifer Lynn Ironside, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60252447 Issued in WA

Practice address

7308 Bridgeport Way W
Suite 103
Lakewood, WA 98499-8000

Phone

(253) 582-8142

Fax

(253) 582-8160

NPI assigned

Feb 8, 2012

Last updated

Nov 18, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complete Physical Therapy PSGroup PAC ID 7113275280, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Complete Physical Therapy P.S.

  • Physical Therapy Clinic/Center
  • Lakewood, WA
  • NPI 1063902385
  Medicare reassignment Care Compare group NPD
• Complete Physical Therapy P.S.

  • Physical Therapist
  • Lakewood, WA
  • NPI 1598499030
  NPD

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1457623290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 ORCHARD ST W",
            "address_2": "SUITE 100",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666606",
            "telephone_number": "253-564-1560",
            "fax_number": "253-564-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W",
            "address_2": "SUITE 103",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-8142",
            "fax_number": "253-582-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRONSIDE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60252447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.