Therapist Central, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2030 Issued in HI

Legal business name

THERAPIST CENTRAL, INC.

Doing business as

Seawolf Physical Therapy

Practice address

12201 Industry Way Ste 4
Anchorage, AK 99515-4316

Phone

(907) 677-9653

Fax

(907) 677-9657

NPI assigned

Oct 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Korre Leigh Pieper, PTNPI 1427100122

Title

President

Phone

(907) 677-9653

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Seawolf Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Practitioners 4

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

• Korre Leigh Pieper, P.T.

  • Physical Therapist
  • Anchorage, AK
  • NPI 1427100122
  Medicare reassignment Authorized official
• Ruby Anna Raymundo Bulaoat, DPT

  • Physical Therapist
  • Anchorage, AK
  • NPI 1538618111
  Medicare reassignment NPD
• Taylor Ravoyd Liles, PT, DPT

  • Physical Therapist
  • Eielson Afb, AK
  • NPI 1699364877
  Medicare reassignment NPD
• Robyn Lynn Brokaw, PT

  • Physical Therapist
  • Duluth, MN
  • NPI 1518010685
  NPD (past)

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1700074382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 INDUSTRY WAY STE 4",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995154316",
            "telephone_number": "907-677-9653",
            "fax_number": "907-677-9657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 INDUSTRY WAY STE 4",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995154316",
            "telephone_number": "907-677-9653",
            "fax_number": "907-677-9657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1063 Lower Main St",
            "address_2": "Suite C 213",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932038",
            "country_code": "US",
            "telephone_number": "808-243-7870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPIST CENTRAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "PIEPER",
        "authorized_official_first_name": "KORRE",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-677-9653",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "HI",
            "license": "2030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1694215",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seawolf Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Woodward Home
• Kaci Eileen Thedford-McCrea
• Sandra Theiler, APRN
• Melanie Thelen, PA-C
• William David Theobald, DDS
• Therapy by Deesign, LLC
• Therapy Solutions of Alaska
• Ruth Therriault
• Jennifer Rose Theulen
• Alisa Thiede

• Physical Therapy Clinic/Center in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physical Therapy Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.