Individual provider Active NPI

Andrea Noel Knapp, PT

  • Physical Therapist
  • Normandy Park, WA
National Provider Identifier
1467562447
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-00006313 Issued in WA
Practice address
17833 1St Ave S Ste a
Normandy Park, WA 98148-1713
Phone
(253) 330-8518
Fax
(253) 330-8519
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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 PT-00006313 WA Primary

Addresses

Primary practice location

17833 1St Ave S Ste a
Normandy Park, WA 98148-1713

Mailing address

1940 S Bonito Way Ste 190
Meridian, ID 83642-5618
Phone (208) 287-9420

Other names 1

  • Andrea Noel Grande Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090826000869 WA Practitioner - Physical Therapist in Private Practice 7719032713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kintsugi Physical TherapyGroup PAC ID 9537593298, 5 clinicians

Practice addresses (Care Compare)

17833 1St Ave S
Suite a
Normandy Park, WA 98148-1713
Phone (253) 220-4099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-00006313WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kintsugi Physical Therapy Physical Therapist CurrentSince Aug 24, 2020 Accepting new patients
Highline Physical Therapy Group Physical Therapist CurrentSince May 17, 2009 Accepting new patients
Highline Physical Therapy Group Physical Therapist CurrentSince May 17, 2009 Accepting new patients

Locations

1940 S Bonito Way
Ste 190
Meridian, ID 83642

2965 E Tarpon Dr
Ste 150
Meridian, ID 83642
Phone 2082879420110

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

16259 Sylvester Rd SW
Ste 102
Burien, WA 98166
Phone (206) 242-5186

17833 1st Ave S
Ste A
Normandy Park, WA 98148
Phone (253) 220-4099

Organizations & group practices 3

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1467562447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17833 1ST AVE S STE A",
            "city": "NORMANDY PARK",
            "state": "WA",
            "postal_code": "981481713",
            "telephone_number": "253-330-8518",
            "fax_number": "253-330-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "ANDREA",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT-00006313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "GRANDE",
            "middle_name": "NOEL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Normandy Park, WA

Sources for this page

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