Kelly F Risse, MPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT8428 Issued in WA

Practice address

3020 S Grand Blvd
Spokane, WA 99203

Phone

(509) 456-6917

Fax

(509) 456-5902

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Therapy Associates PSGroup PAC ID 7810885662, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physical Therapy Associates PS

  • Physical Medicine & Rehabilitation Physician
  • Spokane, WA
  • NPI 1306985700
  Medicare reassignment Care Compare group NPD
• Physical Therapy Associates

  • Multi-Specialty Clinic/Center
  • Spokane, WA
  • NPI 1225372915
  NPD (past) Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629118401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99203",
            "telephone_number": "509-456-6917",
            "fax_number": "509-456-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99203",
            "telephone_number": "509-456-6917",
            "fax_number": "509-456-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSE",
        "first_name": "KELLY",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "PT8428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8332785",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Lin Risdon
• Sandra Riser Jr.
• Arakni Jo Rising, MPT
• Cailyn Elizabeth Risinger, RDH
• John B Risse, PT
• Rita Lu Endodontics
• James Jonathan Ritchey, ABN
• Travis D Ritchie
• Morgan Rittenbach
• Mona L Rittenhouse, PA-C

• Physical Medicine & Rehabilitation Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.