Individual provider Active NPI

Alexandra Souther, DPT

  • Physical Therapist
  • Snohomish, WA
National Provider Identifier
1477222602
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61204943 Issued in WA
Practice address
1409 Avenue D
Snohomish, WA 98290-1713
Phone
(360) 453-7933
NPI assigned
Sep 10, 2021
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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 PT61204943 WA Primary

Addresses

Primary practice location

1409 Avenue D
Snohomish, WA 98290-1713

Mailing address

1409 Avenue D
Snohomish, WA 98290-1713
Phone (360) 453-7933

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211004003387 WA Practitioner - Physical Therapist in Private Practice 8426456559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Washington School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NSPT IncGroup PAC ID 5698850295, 26 clinicians

Practice addresses (Care Compare)

1409 Ave D
Snohomish, WA 98290-1713
Phone (360) 453-7933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NSPT, Inc. Single Specialty CurrentSince Sep 14, 2021 Accepting new patients
NSPT, Inc. Physical Therapist CurrentSince Sep 14, 2021 Accepting new patients

Locations

1409 Avenue D
Snohomish, WA 98290
Phone (360) 453-7933

27500 102nd Ave NW
Ste 1
Stanwood, WA 98292
Phone (360) 629-7528

Organizations & group practices 2

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1477222602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 AVENUE D",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982901713",
            "telephone_number": "360-453-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 AVENUE D",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982901713",
            "telephone_number": "360-453-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHER",
        "first_name": "ALEXANDRA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61204943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snohomish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.