Active NPI
Premere Rehab LLC
- Physical Therapist
- Shoreline, WA
National Provider Identifier
1699027243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PREMERE REHAB LLC
- Practice address
- 14900 1St Ave NE
Shoreline, WA 98155-6800 - Phone
- (206) 279-3448
- NPI assigned
- Oct 5, 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
- Laura Cantrell, PT
- Title
- Director of Outpatient
- Phone
- (360) 901-8111
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
14900 1St Ave NE
Shoreline, WA 98155-6800
Mailing address
25117 SW Parkway Ave
Suite D
Wilsonville, OR 97070-9697
Phone (888) 757-3422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110526000548 | WA | Part B Supplier - Clinic/Group Practice | 2567434764 |
Receives reassigned benefits from 13 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cheney, WA; Yakima, WA; Tacoma, WA; Silverdale, WA; Seattle, WA; Puyallup, WA; Camas, WA; Bothell, WA… |
Other NPIs on the same Medicare enrollment 25
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Prestige Senior Living Bridgewood
- Physical Therapist
- Vancouver, WA
- NPI 1588063242
O20110526000548
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349395200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1357084800000",
"number": "1699027243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE",
"address_2": "SUITE D",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697",
"telephone_number": "888-757-3422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14900 1ST AVE NE",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981556800",
"telephone_number": "206-279-3448"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMERE REHAB LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-05",
"last_updated": "2013-01-02",
"status": "A",
"authorized_official_last_name": "CANTRELL",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT",
"authorized_official_telephone_number": "360-901-8111",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shoreline, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.