NPIMap

Organization Active NPI

Dirksen Physical Therapy Inc PS

  • Physical Therapist
  • Port Hadlock, WA
National Provider Identifier
1609890029
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DIRKSEN PHYSICAL THERAPY INC PS
Practice address
27 Colwell Street
Port Hadlock, WA 98339
Phone
(360) 385-9310
Fax
(360) 379-8826
NPI assigned
Jul 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jeanne Dirksen, PTNPI 1972521672
Title
Owner
Phone
(360) 385-9310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

27 Colwell Street
Port Hadlock, WA 98339

Mailing address

PO Box 897
Port Hadlock, WA 98339-0897
Phone (360) 385-9310

Other identifiers 1

IdentifierTypeStateIssuer
7087661MedicaidWA

Other names 1

  • Dirksen Physical Therapy Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609890029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "PORT HADLOCK",
            "state": "WA",
            "postal_code": "983390897",
            "telephone_number": "360-385-9310",
            "fax_number": "360-379-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 COLWELL STREET",
            "city": "PORT HADLOCK",
            "state": "WA",
            "postal_code": "98339",
            "telephone_number": "360-385-9310",
            "fax_number": "360-379-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRKSEN PHYSICAL THERAPY INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIRKSEN",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-385-9310",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7087661",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dirksen Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Hadlock, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.