Individual provider Active NPI

Kelly A Frick, MSPT

  • Physical Therapist
  • Arlington, WA
National Provider Identifier
1497895072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006526 Issued in WA
Practice address
16404 Smokey Point Blvd Ste 101
Arlington, WA 98223-8417
Phone
(360) 658-8100
Fax
(360) 658-0508
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT00006526 WA Primary

Addresses

Primary practice location

16404 Smokey Point Blvd Ste 101
Arlington, WA 98223-8417

Mailing address

16404 Smokey Point Blvd Ste 101
Arlington, WA 98223-8417
Phone (360) 658-8100

Other identifiers 1

IdentifierTypeStateIssuer
8335358MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080930000694 WA Practitioner - Physical Therapist in Private Practice 9335216522 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Luna Care Physical Therapy LLCGroup PAC ID 7416283817, 161 clinicians
Peak Sports and Spine Physical Therapy Lake City PSGroup PAC ID 2163524182, 6 clinicians
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

Bellevue, WA 98006
Phone (866) 525-3175

11545 15TH Ave NE
Suite 205
Seattle, WA 98125-6358
Phone (206) 417-1298

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-2560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00006526WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Sports and Spine Physical Therapy Lake City PS Physical Therapist CurrentSince Feb 1, 2021 Accepting new patients

Locations

11545 15th Ave NE
Ste 205
Seattle, WA 98125
Phone (206) 364-2010

Organizations & group practices 4

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497895072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16404 SMOKEY POINT BLVD STE 101",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238417",
            "telephone_number": "360-658-8100",
            "fax_number": "360-658-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16404 SMOKEY POINT BLVD STE 101",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238417",
            "telephone_number": "360-658-8100",
            "fax_number": "360-658-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICK",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8335358",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.