Organization Active NPI

Ablan PT LLC

  • Physical Therapist
  • Kelso, WA
National Provider Identifier
1619549417
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ABLAN PT LLC
Practice address
351 Three Rivers Dr Ste 1137
Kelso, WA 98626-3129
Phone
(360) 270-4199
NPI assigned
Jul 13, 2021
Last updated
Sep 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Thomas Ablan, DPTNPI 1336391705
Title
Physical Therapist/Owner
Phone
(360) 270-4199

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 Therapist 225100000X NU Primary

Addresses

Primary practice location

351 Three Rivers Dr Ste 1137
Kelso, WA 98626-3129

Mailing address

2737 Harris Street Rd
Kelso, WA 98626-5312
Phone (360) 270-4199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211119001904 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2163811720 Receives reassigned benefits from 2 practitioners
Practice locations: Kelso, WA

National Provider Directory

National Provider Directory

Locations

351 Three Rivers Dr
Ste 1137
Kelso, WA 98626
Phone (360) 270-4199

351 Three Rivers Dr
Ste 137
Kelso, WA 98626
Phone (360) 270-4199

Practitioners & affiliated clinicians

Practitioners 4

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": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1619549417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2737 HARRIS STREET RD",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986265312",
            "telephone_number": "360-270-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 THREE RIVERS DR STE 1137",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986263129",
            "telephone_number": "360-270-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABLAN PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "ABLAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "360-270-4199",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kelso, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.