NPIMap

Organization Active NPI

Puyallup Valley Physical Therapy, Inc. P. S.

  • Orthopedic Physical Therapist
  • Puyallup, WA
National Provider Identifier
1619060308
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
PUYALLUP VALLEY PHYSICAL THERAPY, INC. P. S.
Practice address
2520 7TH St. SE
Puyallup, WA 98374-1105
Phone
(253) 848-2309
Fax
(253) 848-8407
NPI assigned
Oct 2, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Mrs. Joyce L. Miller, PTNPI 1023102571
Title
Vice President
Phone
(253) 848-2309

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
Orthopedic Physical Therapist 2251X0800X WA Primary

Addresses

Primary practice location

2520 7TH St. SE
Puyallup, WA 98374-1105

Mailing address

2520 7TH St. SE
Puyallup, WA 98374-1105
Phone (253) 848-2309

Other identifiers 1

IdentifierTypeStateIssuer
7206204MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040415001213 WA Part B Supplier - Clinic/Group Practice 7517952914 Receives reassigned benefits from 11 practitioners
Practice locations: Puyallup, WA
O20250512001792 WA DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 7517952914 Practice locations: Puyallup, WA

National Provider Directory

National Provider Directory

Locations

2520 7th St SE
Puyallup, WA 98374
Phone (206) 848-2309

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1619060308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 7TH ST. SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741105",
            "telephone_number": "253-848-2309",
            "fax_number": "253-848-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 7TH ST. SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741105",
            "telephone_number": "253-848-2309",
            "fax_number": "253-848-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUYALLUP VALLEY PHYSICAL THERAPY, INC. P. S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "253-848-2309",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7206204",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.