NPIMap

Organization Active NPI

Integrated Rehabilitation Group, PC

  • Physical Therapy Clinic/Center
  • Granite Falls, WA
National Provider Identifier
1699716332
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
INTEGRATED REHABILITATION GROUP, PC
Doing business as
Granite Falls Physical Therapy
IRG Physical & Hand Therapy - Granite Falls
Practice address
403 W Stanley St
Granite Falls, WA 98252-8631
Phone
(360) 691-4835
Fax
(360) 691-2545
NPI assigned
Jun 10, 2006
Organization subpart
Yes
Parent organization
INTEGRATED REHABILITATION GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Authorized official

Name
Michael Shannon O'Kelley, MPT
Title
President/Owner
Phone
(425) 316-8046

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

403 W Stanley St
Granite Falls, WA 98252-8631

Mailing address

4220 132ND St SE
Suite 101
Mill Creek, WA 98012-8999
Phone (425) 316-8046

Other identifiers 7

IdentifierTypeStateIssuer
0159241OtherWADEPT. OF LABOR & INDUSTRY
462797002OtherWAGROUP HEALTH MEDICARE
8928201OtherWAL&I CRIME VICTIMS
3791726-04OtherWAOWCP
7083322MedicaidWA
462797005OtherWAGROUP HEALTH NON-MEDICARE
9055039MedicaidWA

Other names 2

  • Granite Falls Physical Therapy Doing business as
  • IRG Physical & Hand Therapy - Granite Falls Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Integrated Rehab Group Inc38 organizations share this tax ID, including this one
Part of
Integrated Rehab Group Inc

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1699716332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 132ND ST SE",
            "address_2": "SUITE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980128999",
            "telephone_number": "425-316-8046",
            "fax_number": "425-338-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W STANLEY ST",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528631",
            "telephone_number": "360-691-4835",
            "fax_number": "360-691-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHABILITATION GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED REHABILITATION GROUP, PC",
        "enumeration_date": "2006-06-10",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "O'KELLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "425-316-8046",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR & INDUSTRY",
            "identifier": "0159241",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH MEDICARE",
            "identifier": "462797002",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8928201",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "3791726-04",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7083322",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH NON-MEDICARE",
            "identifier": "462797005",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9055039",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Falls Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Granite Falls Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IRG Physical & Hand Therapy - Granite Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granite Falls, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.