Centennial Sports & Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00009613 Issued in WA

Legal business name

CENTENNIAL SPORTS & PHYSICAL THERAPY LLC

Practice address

13102 E Mission Ave
Spokane Valley, WA 99216-1142

Phone

(509) 928-6220

Fax

(509) 928-7597

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

Sean Freeman, PTNPI 1306910914

Title

Owner Physical Therapist

Phone

(509) 928-6220

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 2

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

• Sean Freeman, PT

  • Physical Therapist
  • Spokane Valley, WA
  • NPI 1306910914
  Medicare reassignment NPD Authorized official
• Steven Barlow, FNP

  • Family Nurse Practitioner
  • Grand Forks, ND
  • NPI 1275815680
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1659427003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13102 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161142",
            "telephone_number": "509-928-6220",
            "fax_number": "509-928-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13102 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161142",
            "telephone_number": "509-928-6220",
            "fax_number": "509-928-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL SPORTS & PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "509-928-6220",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "196030",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7136989",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "DF5882",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS",
            "identifier": "5230FR",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00377246",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Marie Cecil, C.B.D., P.S.
• Cedarcrest Behavioral Medicine LLC
• Hope Cedeno, BSN, RN
• Hilda Celestino
• John R Celestino, PT, GCS. MTC. CSCS
• Centerwell Certified Healthcare Corp.
• Centerwell Certified Healthcare Corp.
• Central Valley School District
• Central Valley School District#356
• Cody Ross Chamberlain

• Physical Therapist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.