Individual provider Active NPI

Ryan Edward Madison, PT, MS

  • Physical Therapist
  • Tacoma, WA
National Provider Identifier
1568505790
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008956 Issued in WA
Practice address
5032 N Vassault St
Tacoma, WA 98407-1333
Phone
(425) 422-2633
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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 PT00008956 WA Primary

Addresses

Primary practice location

5032 N Vassault St
Tacoma, WA 98407-1333

Mailing address

5032 N Vassault St
Tacoma, WA 98407-1333
Phone (425) 422-2633

Other identifiers 2

IdentifierTypeStateIssuer
163564OtherWALABOR AND INDUSTRY
8337016MedicaidWA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT00008956WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stanwood-Camano Physical Therapy, PLLC Physical Therapist PastSince Aug 1, 2005 Accepting new patients
Point Fosdick Physical Therapy, Inc PS Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1568505790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5032 N VASSAULT ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984071333",
            "telephone_number": "425-422-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5032 N VASSAULT ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984071333",
            "telephone_number": "425-422-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "RYAN",
        "middle_name": "EDWARD",
        "credential": "PT, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRY",
            "identifier": "163564",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8337016",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.