Active NPI
Susan Kristy Gibbons, P.T.
- Physical Therapist
- Issaquah, WA
National Provider Identifier
1598096133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 00008044
- Practice address
- 1495 NW Gilman Blvd
Suite 4
Issaquah, WA 98027-8975 - Phone
- (425) 394-1200
- NPI assigned
- Jan 21, 2010
- Sex
- Female
- Sole proprietor
- No
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 | PT 00008044 | WA | Primary |
Addresses
Primary practice location
1495 NW Gilman Blvd
Suite 4
Issaquah, WA 98027-8975
Mailing address
7970 E Mercer Way
Mercer Island, WA 98040-5824
Phone (206) 275-4074
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 00008044 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264032000000",
"number": "1598096133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7970 E MERCER WAY",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980405824",
"telephone_number": "206-275-4074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1495 NW GILMAN BLVD",
"address_2": "SUITE 4",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278975",
"telephone_number": "425-394-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "SUSAN",
"middle_name": "KRISTY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-21",
"last_updated": "2010-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT 00008044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.