Organization Active NPI

Restoration Rehabilitation Inc

  • Physical Therapist
  • Rochester, WA
National Provider Identifier
1508196502
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00003851 Issued in WA
Legal business name
RESTORATION REHABILITATION INC
Practice address
10119 Highway 12 SW
Rochester, WA 98579-8621
Phone
(360) 273-4747
Fax
(360) 273-4747
NPI assigned
Jan 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Authorized official

Name
Lisa A Scheuffele, P.T.NPI 1730367368
Title
Owner/ President
Phone
(253) 549-5668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT00003851 WA Primary

Addresses

Primary practice location

10119 Highway 12 SW
Rochester, WA 98579-8621

Mailing address

PO Box 306
Fox Island, WA 98333-0306
Phone (360) 273-4747

Other identifiers 3

IdentifierTypeStateIssuer
7145766MedicaidWA
2496SCOtherWAREGENCE BLUE SHIELD
236625OtherWADEPARTMENT OF LABOR & INDUSTRIES

Other names 1

  • Restoration Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100329000796 WA Part B Supplier - Clinic/Group Practice 6507992559 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester, WA

National Provider Directory

National Provider Directory

Locations

18328 Albany St SW
Rochester, WA 98579
Phone (360) 273-4747

10115 Highway 12 SW
Rochester, WA 98579

Practitioners & affiliated clinicians

Practitioners 1

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": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1508196502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "FOX ISLAND",
            "state": "WA",
            "postal_code": "983330306",
            "telephone_number": "360-273-4747",
            "fax_number": "360-273-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10119 HIGHWAY 12 SW",
            "city": "ROCHESTER",
            "state": "WA",
            "postal_code": "985798621",
            "telephone_number": "360-273-4747",
            "fax_number": "360-273-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "SCHEUFFELE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "253-549-5668",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7145766",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "2496SC",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR & INDUSTRIES",
            "identifier": "236625",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.