Individual provider Active NPI

Jennifer Clinton

  • Physical Therapist
  • Spokane, WA
National Provider Identifier
1609320498
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60659339 Issued in WA
Practice address
1111 W Wellesley Ave
Spokane, WA 99205-1274
Phone
(509) 448-9358
NPI assigned
Aug 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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 60659339 WA Primary

Addresses

Primary practice location

1111 W Wellesley Ave
Spokane, WA 99205-1274

Mailing address

1111 W Wellesley Ave
Spokane, WA 99205-1274
Phone (509) 448-9358

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

LicenseStateTypeSpecialty
60659339WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayonne Physical Therapy Inc Physical Therapist Past Accepting new patients
Jerry M Johnson Etal PTR Four Seasons Physical Therapy PastSince Aug 1, 2000 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1609320498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W WELLESLEY AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051274",
            "telephone_number": "509-448-9358",
            "fax_number": "509-448-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W WELLESLEY AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051274",
            "telephone_number": "509-448-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60659339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.