Individual provider Active NPI

Sean Knight, PT

  • Physical Therapist
  • Pullman, WA
National Provider Identifier
1568879096
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60483732 Issued in WA
Practice address
1225 S Grand Ave Ste B
Pullman, WA 99163-5289
Phone
(714) 369-5706
NPI assigned
Jul 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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 PT60483732 WA Primary

Addresses

Primary practice location

1225 S Grand Ave Ste B
Pullman, WA 99163-5289

Mailing address

280 SW Sanna CT
Pullman, WA 99163-5252
Phone (714) 369-5706

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905000163 WA Practitioner - Physical Therapist in Private Practice 1355569252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proformance Physical Therapy, LLCGroup PAC ID 0840229480, 5 clinicians

Practice addresses (Care Compare)

1225 S Grand Ave
Suite B
Pullman, WA 99163-5289
Phone (509) 338-9204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60483732WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proformance Physical Therapy, LLC Physical Therapist CurrentSince Jul 22, 2014 Accepting new patients

Locations

1225 S Grand Ave
Ste B
Pullman, WA 99163
Phone (509) 338-9204

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1568879096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SW SANNA CT",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635252",
            "telephone_number": "714-369-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GRAND AVE STE B",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635289",
            "telephone_number": "714-369-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "SEAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60483732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.