Individual provider Active NPI

Larry D Farnes

  • Specialist
  • University Place, WA
National Provider Identifier
1609850528
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT00000922 Issued in WA
Practice address
4007 Bridgeport Way W
Suite C
University Place, WA 98466-4330
Phone
(253) 565-7529
Fax
(253) 399-2508
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT00000922 WA Primary

Addresses

Primary practice location

4007 Bridgeport Way W
Suite C
University Place, WA 98466-4330

Mailing address

4007 Bridgeport Way W
Suite C
University Place, WA 98466-4330
Phone (253) 565-7529

Other names 1

  • Larry D Farnes Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111108000910 WA Practitioner - Physical Therapist in Private Practice 2961494042 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
922WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC CurrentSince Oct 24, 2017 Accepting new patients
Apple Physical Therapy, LLC Current Accepting new patients
Apple Physical Therapy LLC CurrentSince Oct 24, 2017 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

21806 103rd Avenue Ct E
Ste 103
Graham, WA 98338
Phone (253) 847-3700

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

Organizations & group practices 3

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1609850528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 BRIDGEPORT WAY W",
            "address_2": "SUITE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664330",
            "telephone_number": "253-565-7529",
            "fax_number": "253-399-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 BRIDGEPORT WAY W",
            "address_2": "SUITE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664330",
            "telephone_number": "253-565-7529",
            "fax_number": "253-399-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNES",
        "first_name": "LARRY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "PT00000922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "FARNES",
            "middle_name": "D",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.