Active NPI
Michael John Bagby, DPT
- Physical Therapist
- Lynnwood, WA
National Provider Identifier
1528464849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60478657
- Practice address
- 6101 200TH St SW Ste 208
Lynnwood, WA 98036-6077 - Phone
- (425) 778-2325
- Fax
- (425) 778-7692
- NPI assigned
- Nov 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60478657 | Primary |
Addresses
Primary practice location
6101 200TH St SW Ste 208
Lynnwood, WA 98036-6077
Mailing address
PO Box 156
Coupeville, WA 98239-0156
Phone (360) 269-1723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc P S | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Proliance Orthopedic Associates
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415836800000",
"number": "1528464849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 156",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "982390156",
"telephone_number": "360-269-1723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 200TH ST SW STE 208",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366077",
"telephone_number": "425-778-2325",
"fax_number": "425-778-7692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGBY",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-13",
"last_updated": "2014-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": "PT60478657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.