Individual provider Active NPI

Emmanuel K Acheampong Jr., PT, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1629634332
Registry record updated Jul 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24223 Issued in MA
Practice address
2720 4TH Ave Apt 115
Seattle, WA 98121
Phone
(206) 279-2870
Fax
(206) 279-2872
NPI assigned
May 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2019

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 24223 MA Primary

Addresses

Primary practice location

2720 4TH Ave Apt 115
Seattle, WA 98121

Mailing address

2720 4TH Ave Apt 115
Seattle, WA 98121-1388
Phone (206) 279-2870

Other practice location 1

904C Boston Tpke
Shrewsbury, MA 01545-3303
Phone (508) 845-5000

Other practice location 2

904C Boston Tpke
Shrewsbury, MA 01545-3303
Phone (508) 845-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190905001301 WA Practitioner - Physical Therapist in Private Practice 5395074082 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24223MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Physical Therapy, PLLC Physical Therapist CurrentSince Aug 5, 2019 Accepting new patients

Locations

2720 4th Ave
Apt 115
Seattle, WA 98121
Phone (206) 279-2870

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563580800000",
    "number": "1629634332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 4TH AVE APT 115",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211388",
            "telephone_number": "206-279-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 4TH AVE APT 115",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98121",
            "telephone_number": "206-279-2870",
            "fax_number": "206-279-2872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904C Boston Tpke",
            "address_purpose": "LOCATION",
            "city": "Shrewsbury",
            "state": "MA",
            "postal_code": "015453303",
            "country_code": "US",
            "telephone_number": "508-845-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "904C Boston Tpke",
            "address_purpose": "LOCATION",
            "city": "Shrewsbury",
            "state": "MA",
            "postal_code": "015453303",
            "country_code": "US",
            "telephone_number": "508-845-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACHEAMPONG",
        "first_name": "EMMANUEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2019; 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.