Bainbridge Island Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00008747 Issued in WA

Legal business name

BAINBRIDGE ISLAND PHYSICAL THERAPY, LLC

Practice address

563 Madison Ave N
Bainbridge Island, WA 98110-1768

Phone

(206) 855-8455

Fax

(206) 855-8465

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer Heinzelman

Title

Owner/ Manager

Phone

(206) 855-8880

Specialties & licenses 11

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teresa N Barbery, DPT

  • Physical Therapist
  • Silverdale, WA
  • NPI 1962133942
  Medicare reassignment Care Compare group NPD
• Alexander Dean Beekman, DPT

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1619702339
  Medicare reassignment Care Compare group NPD
• Kelly Leighton Danielson, OTD, MOT, OTR/L

  • Occupational Therapist
  • Bainbridge Island, WA
  • NPI 1568250942
  Medicare reassignment Care Compare group NPD
• Tricia Ann Fong, MSPT

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1336224591
  Medicare reassignment Care Compare group NPD
• Keith Ronald Heinzelman, DPT, CHT, MTC

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1194826479
  Medicare reassignment Care Compare group NPD
• Matthew Holbert, PT, DPT

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1417641507
  Medicare reassignment Care Compare group NPD
• Sharon Lynn Kuznetsov, OTR/L, CHT

  • Occupational Therapist
  • Bainbridge Island, WA
  • NPI 1043264518
  Medicare reassignment Care Compare group NPD
• Liam Ratcliffe, PT, DPT

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1285564336
  Medicare reassignment Care Compare group NPD
• Lynelle Marie Watson, PT, DPT, MFDC

  • Physical Therapist
  • Seattle, WA
  • NPI 1972062362
  Medicare reassignment Care Compare group NPD
• Danaher Dempsey, PT

  • Physical Therapist
  • Poulsbo, WA
  • NPI 1538654769
  Medicare reassignment NPD
• Morgan Elisabeth Moniz, DPT

  • Physical Therapist
  • Poulsbo, WA
  • NPI 1679155931
  Medicare reassignment NPD
• Lynn Ahlin Hutchinson, P.T.

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1023146172
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1639219868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 MADISON AVE N",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101768",
            "telephone_number": "206-855-8455",
            "fax_number": "206-855-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 MADISON AVE N",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101768",
            "telephone_number": "206-855-8455",
            "fax_number": "206-855-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAINBRIDGE ISLAND PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "HEINZELMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "206-855-8880"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008747",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007979",
            "primary": false
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": "WA",
            "license": "PT00007979",
            "primary": false
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Ergonomics",
            "state": "WA",
            "license": "PT00007979",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WA",
            "license": "PT00007979",
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": "WA",
            "license": "PT00008747",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "WA",
            "license": "PT00008747",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "WA",
            "license": "PT00007979",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT00008747",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT00007979",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRY",
            "identifier": "0184534",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7132533",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7375455",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bainbridge Island Ambulance Association Inc
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• Bainbridge Island School District
• Bainbridge Mental Health, PLLC (Sport Psych MD)
• Bainbridge Pediatric Therapy
• Bainbridge Pediatrics, PLLC
• Bainbridge Skin Surgery and Consultative Dermatology PLLC

• Physical Therapist in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.