NPIMap

Organization Active NPI

Renton Sports & Spine PT

  • Physical Therapist
  • Renton, WA
National Provider Identifier
1528068533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009793 Issued in WA
Legal business name
RENTON SPORTS & SPINE PT
Practice address
4361 Talbot Rd S
Suite 100
Renton, WA 98055-6226
Phone
(425) 917-9885
Fax
(425) 917-2334
NPI assigned
Aug 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Joel M Johnson, PT
Title
Director/Physical Therapist
Phone
(425) 917-9885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT00009793 WA Primary

Addresses

Primary practice location

4361 Talbot Rd S
Suite 100
Renton, WA 98055-6226

Mailing address

4361 Talbot Rd S
Suite 100
Renton, WA 98055-6226
Phone (425) 917-9885

National Provider Directory

National Provider Directory
Tax ID family
Renton Sports Spine PT2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528068533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 TALBOT RD S",
            "address_2": "SUITE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556226",
            "telephone_number": "425-917-9885",
            "fax_number": "425-917-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 TALBOT RD S",
            "address_2": "SUITE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556226",
            "telephone_number": "425-917-9885",
            "fax_number": "425-917-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENTON SPORTS & SPINE PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "425-917-9885",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.