Individual provider Active NPI

Amy I Lynch, PT

  • Physical Therapist
  • Port Hadlock, WA
National Provider Identifier
1619995396
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007149 Issued in WA
Practice address
27 Colwell Street
Port Hadlock, WA 98339-0897
Phone
(360) 385-9310
Fax
(360) 379-8826
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00007149 WA Primary

Addresses

Primary practice location

27 Colwell Street
Port Hadlock, WA 98339-0897

Mailing address

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

Other identifiers 7

IdentifierTypeStateIssuer
8374696OtherWADSHS
7824409OtherWAAETNA
G8862188OtherWAMEDICARE GROUP NUMBER
A003OtherWATRICARE WEST
8374696MedicaidWA
5116LYOtherWAREGENCE BLUE SHIELD
8943400OtherWACRIME VICTIMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040210000985 WA Practitioner - Physical Therapist in Private Practice 6204720337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 897
Port Hadlock, WA 98339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00007149WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Discovery Physical Therapy Inc., P.S. CurrentSince Jan 1, 2007 Accepting new patients
Dirksen Physical Therapy Inc PS Physical Therapist Past Accepting new patients

Locations

27 Colwell St
Port Hadlock, WA 98339
Phone (360) 344-8571

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1619995396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0897",
            "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": "983390897",
            "telephone_number": "360-385-9310",
            "fax_number": "360-379-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "AMY",
        "middle_name": "I",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "8374696",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7824409",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "G8862188",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "A003",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8374696",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "5116LY",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8943400",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.