Active NPI
Forty Six & Two, LLC
- Physical Therapy Clinic/Center
- Spokane, WA
National Provider Identifier
1659627974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- PT00008588
- Legal business name
- FORTY SIX & TWO, LLC
- Practice address
- 8801 N Indian Trail Rd Ste I
Spokane, WA 99208-6052 - Phone
- (509) 465-4799
- NPI assigned
- Jul 24, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ryan B Stern, DPT
- Title
- Owner
- Phone
- (509) 979-5981
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | PT00008588 | WA | Primary |
Addresses
Primary practice location
8801 N Indian Trail Rd Ste I
Spokane, WA 99208-6052
Mailing address
8801 N Indian Trail Rd Ste I
Spokane, WA 99208-6052
Phone (509) 465-4799
Other names 1
- Indian Trail Physical Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120831000129 | WA | Part B Supplier - Clinic/Group Practice | 1355598012 |
Receives reassigned benefits from 4 practitioners Practice locations: Spokane, WA; Chattaroy, WA |
National Provider Directory
National Provider DirectoryLocations
34705 N Newport Hwy
Ste D
Chattaroy, WA 99003
Phone (509) 292-9986
2532 W Francis Ave
Spokane, WA 99205
Phone (509) 465-4799
Practitioners & affiliated clinicians
Practitioners 4
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": "1343088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1343088000000",
"number": "1659627974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8801 N INDIAN TRAIL RD STE I",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992086052",
"telephone_number": "509-465-4799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 N INDIAN TRAIL RD STE I",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992086052",
"telephone_number": "509-465-4799"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORTY SIX & TWO, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-24",
"last_updated": "2012-07-24",
"status": "A",
"authorized_official_last_name": "STERN",
"authorized_official_first_name": "RYAN",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "509-979-5981",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "WA",
"license": "PT00008588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Indian Trail Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.