NPIMap

Organization Active NPI

Bruce Harlow Whiteside

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1477699783
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
601496566 Issued in WA
Legal business name
BRUCE HARLOW WHITESIDE
Practice address
3909 Castlevale Rd
Suite 100
Yakima, WA 98902-7800
Phone
(509) 457-0202
Fax
(509) 457-0404
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Bruce Harlow Whiteside, PT
Title
Owner
Phone
(509) 457-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 601496566 WA Primary

Addresses

Primary practice location

3909 Castlevale Rd
Suite 100
Yakima, WA 98902-7800

Mailing address

3909 Castlevale Rd
Suite 100
Yakima, WA 98902-7800
Phone (509) 457-0202

Other identifiers 1

IdentifierTypeStateIssuer
7059157MedicaidWA

Other names 1

  • ORTHOPEDIC PHYSICAL THERAPY Doing business as

National Provider Directory

National Provider Directory

Locations

3909 Castlevale Rd
Ste 100
Yakima, WA 98902
Phone (509) 457-0202

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1477699783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 CASTLEVALE RD",
            "address_2": "SUITE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027800",
            "telephone_number": "509-457-0202",
            "fax_number": "509-457-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 CASTLEVALE RD",
            "address_2": "SUITE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027800",
            "telephone_number": "509-457-0202",
            "fax_number": "509-457-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE HARLOW WHITESIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "WHITESIDE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "HARLOW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-457-0202",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "601496566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7059157",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ORTHOPEDIC PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.