NPIMap

Organization Active NPI

Integrated Rehabilitation Group, PC

  • Physical Therapy Clinic/Center
  • Lacey, WA
National Provider Identifier
1477588010
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
INTEGRATED REHABILITATION GROUP, PC
Practice address
5215 Corporate Center CT SE Ste D
Lacey, WA 98503-5800
Phone
(360) 455-8155
Fax
(360) 455-1655
NPI assigned
Jul 12, 2006
Organization subpart
Yes
Parent organization
INTEGRATED REHABILITATION GROUP, PCAs reported in NPPES

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Practitioners 192

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200903002854 WA DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 0042111718 Practice locations: Lacey, WA

National Provider Directory

National Provider Directory
Tax ID family
Integrated Rehab Group Inc38 organizations share this tax ID, including this one
Part of
Integrated Rehab Group Inc

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Authorized official

Name
Michael S Okelley
Title
Owner
Phone
(425) 316-8046

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5215 Corporate Center CT SE Ste D
Lacey, WA 98503-5800

Mailing address

4220 132ND St SE
Suite 101
Mill Creek, WA 98012-8999
Phone (425) 357-9380

Other identifiers 1

IdentifierTypeStateIssuer
3583413-02OtherWAOWCP

Other names 1

  • South Sound Physical & Hand Therapy-Lacey Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1477588010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 132ND ST SE",
            "address_2": "SUITE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980128999",
            "telephone_number": "425-357-9380",
            "fax_number": "425-357-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 CORPORATE CENTER CT SE STE D",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035800",
            "telephone_number": "360-455-8155",
            "fax_number": "360-455-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHABILITATION GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED REHABILITATION GROUP, PC",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "OKELLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-316-8046"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "3583413-02",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Sound Physical & Hand Therapy-Lacey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.