Active NPI
Jeremy Jacob Korthuis, DPT
- Physical Therapist
- Lynden, WA
National Provider Identifier
1477102630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60944528
- Practice address
- 1824 Front St Ste a
Lynden, WA 98264-1729 - Phone
- (360) 354-0585
- Fax
- (360) 354-1098
- NPI assigned
- Sep 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60944528 | WA | Primary |
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | PTH9560 | AL |
Addresses
Primary practice location
1824 Front St Ste a
Lynden, WA 98264-1729
Mailing address
1824 Front St Ste a
Lynden, WA 98264-1729
Phone (360) 354-0585
Other practice location 1
5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321
Phone (888) 265-2680
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH9560 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764547200000",
"number": "1477102630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1824 FRONT ST STE A",
"city": "LYNDEN",
"state": "WA",
"postal_code": "982641729",
"telephone_number": "360-354-0585",
"fax_number": "360-354-1098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1824 FRONT ST STE A",
"city": "LYNDEN",
"state": "WA",
"postal_code": "982641729",
"telephone_number": "360-354-0585",
"fax_number": "360-354-1098"
}
],
"practiceLocations": [
{
"address_1": "5535 S Williamson Blvd Ste 774",
"address_purpose": "LOCATION",
"city": "Port Orange",
"state": "FL",
"postal_code": "321288321",
"country_code": "US",
"telephone_number": "888-265-2680",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KORTHUIS",
"first_name": "JEREMY",
"middle_name": "JACOB",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-10",
"last_updated": "2025-12-01",
"certification_date": "2025-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60944528",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH9560",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lynden, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.