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Organization Active NPI

Winthrop Physical Therapy PS

  • Sports Physical Therapist
  • Winthrop, WA
National Provider Identifier
1649248154
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
602118917 Issued in WA
Legal business name
WINTHROP PHYSICAL THERAPY PS
Practice address
202 White Ave
Winthrop, WA 98862-9774
Phone
(509) 996-8234
Fax
(509) 996-2193
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Authorized official

Name
Peter B Dickinson, MSPT, SCS
Title
Owner/President
Phone
(509) 996-8234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251S0007X 602118917 WA Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

202 White Ave
Winthrop, WA 98862-9774

Mailing address

PO Box 814
Winthrop, WA 98862-0814
Phone (509) 996-8234

Other identifiers 4

IdentifierTypeStateIssuer
7120769MedicaidWA
602118917OtherWAUNIFIED BUSINESS IDENTIFI
0200051OtherWALABOR & INDUSTRIES
193601200OtherWAUS DEPT OF LABOR OWCP

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1649248154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 814",
            "city": "WINTHROP",
            "state": "WA",
            "postal_code": "988620814",
            "telephone_number": "509-996-8234",
            "fax_number": "509-996-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 WHITE AVE",
            "city": "WINTHROP",
            "state": "WA",
            "postal_code": "988629774",
            "telephone_number": "509-996-8234",
            "fax_number": "509-996-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINTHROP PHYSICAL THERAPY PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "DICKINSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "509-996-8234",
        "authorized_official_credential": "MSPT, SCS"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "WA",
            "license": "602118917",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7120769",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFIED BUSINESS IDENTIFI",
            "identifier": "602118917",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0200051",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR OWCP",
            "identifier": "193601200",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winthrop, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.