Individual provider Active NPI

Ryan Dwain Hedge, DPT

  • Physical Therapist
  • Lacey, WA
National Provider Identifier
1487532800
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT70010624 Issued in WA
Practice address
1445 Galaxy Dr NE Ste 301
Lacey, WA 98516-4754
Phone
(360) 456-1444
NPI assigned
Aug 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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 PT70010624 WA Primary

Addresses

Primary practice location

1445 Galaxy Dr NE Ste 301
Lacey, WA 98516-4754

Mailing address

1445 Galaxy Dr NE Ste 301
Lacey, WA 98516-4754
Phone (360) 456-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251016004794 WA Practitioner - Physical Therapist in Private Practice 0941797401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penrose and Associates Physical Therapy LLCGroup PAC ID 1052403896, 11 clinicians

Practice addresses (Care Compare)

1445 Galaxy Dr NE
Suite 301
Lacey, WA 98516-4754
Phone (360) 456-1444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT70010624WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Penrose & Associates Physical Therapy LLC CurrentSince Sep 2, 2025 Accepting new patients

Locations

1445 Galaxy Dr NE
Ste 301
Lacey, WA 98516
Phone (360) 456-1444

1445 Galaxy Dr NE
Lacey, WA 98516
Phone (360) 456-1444

Organizations & group practices 1

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": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1487532800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 GALAXY DR NE STE 301",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164754",
            "telephone_number": "360-456-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 GALAXY DR NE STE 301",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164754",
            "telephone_number": "360-456-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDGE",
        "first_name": "RYAN",
        "middle_name": "DWAIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT70010624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 25, 2025; 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.