NPIMap

Organization Active NPI

Outpatient Physical Therapy & Sports Rehabilitation Inc PC

  • Physical Therapist
  • Covington, WA
National Provider Identifier
1700108289
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OUTPATIENT PHYSICAL THERAPY & SPORTS REHABILITATION INC PC
Practice address
27005 168TH PL SE
Ste 200
Covington, WA 98042-4902
Phone
(253) 639-4788
NPI assigned
Feb 24, 2010
Last updated
Jan 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Dan B Steele, PT
Title
Owner
Phone
(425) 413-4427

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

27005 168TH PL SE
Ste 200
Covington, WA 98042-4902

Mailing address

26837 Maple Valley Black Diamond Rd SE
Ste 201
Maple Valley, WA 98038-9917
Phone (425) 413-4427

Other identifiers 2

IdentifierTypeStateIssuer
GAB11700OtherWAMEDICARE PTAN
7086606MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1700108289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26837 MAPLE VALLEY BLACK DIAMOND RD SE",
            "address_2": "STE 201",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980389917",
            "telephone_number": "425-413-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 168TH PL SE",
            "address_2": "STE 200",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424902",
            "telephone_number": "253-639-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTPATIENT PHYSICAL THERAPY & SPORTS REHABILITATION INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "STEELE",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-413-4427",
        "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GAB11700",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7086606",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.