Individual provider Active NPI

Morgan Wise, PHYSICAL THERAPIST

  • Physical Therapist
  • Renton, WA
National Provider Identifier
1609484724
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4011 Talbot Rd S FL 1
Renton, WA 98055-5773
Phone
(425) 690-3520
Fax
(425) 690-9520
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT61076196 WA
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4011 Talbot Rd S FL 1
Renton, WA 98055-5773

Mailing address

4011 Talbot Rd S FL 1
Renton, WA 98055-5773
Phone (425) 690-3520

Other practice location 1

1040 Stevenson Ave
Enumclaw, WA 98022-2991
Phone (360) 825-7411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200806002205 WA Practitioner - Physical Therapist in Private Practice 3678999216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT61076196WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Therapy Group Physical Therapist CurrentSince Jul 20, 2020 Accepting new patients
Public Hospital District #1 of King County PastSince Jul 2, 2023 Accepting new patients

Locations

24060 SE Kent Kangley Rd
#D100
Maple Valley, WA 98038
Phone (425) 358-7708

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": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1609484724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S FL 1",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555773",
            "telephone_number": "425-690-3520",
            "fax_number": "425-690-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S FL 1",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555773",
            "telephone_number": "425-690-3520",
            "fax_number": "425-690-9520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 Stevenson Ave",
            "address_purpose": "LOCATION",
            "city": "Enumclaw",
            "state": "WA",
            "postal_code": "980222991",
            "country_code": "US",
            "telephone_number": "360-825-7411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "MORGAN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61076196",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.