NPIMap

Organization Active NPI

Integrated Rehabilitation Group PC

Doing business as Edmonds Physical Therapy & Sports Rehabilitation

  • Physical Therapist
  • Edmonds, WA
National Provider Identifier
1700232964
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
INTEGRATED REHABILITATION GROUP PC
Doing business as
Edmonds Physical Therapy & Sports Rehabilitation
Practice address
7315 212TH St SW
Suite 104
Edmonds, WA 98026-7610
Phone
(425) 774-3226
Fax
(425) 670-1406
NPI assigned
May 6, 2016
Last updated
May 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Authorized official

Name
Michael Shannon Okelley
Title
MPT/President
Phone
(425) 316-8046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

7315 212TH St SW
Suite 104
Edmonds, WA 98026-7610

Mailing address

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

Other names 1

  • Edmonds Physical Therapy & Sports Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Integrated Rehabilitation Group Inc38 organizations share this tax ID, including this one

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": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1700232964",
    "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": "7315 212TH ST SW",
            "address_2": "SUITE 104",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-774-3226",
            "fax_number": "425-670-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHABILITATION GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "OKELLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "MPT/PRESIDENT",
        "authorized_official_telephone_number": "425-316-8046"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edmonds Physical Therapy & Sports Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.