NPIMap

Organization Active NPI

Peak Sports & Spine Physical Therapy - Maple Valley PS

  • Physical Therapy Clinic/Center
  • Maple Valley, WA
National Provider Identifier
1700553674
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PEAK SPORTS & SPINE PHYSICAL THERAPY - MAPLE VALLEY PS
Practice address
22443 SE 240TH St Ste 201
Maple Valley, WA 98038-5879
Phone
(425) 306-4265
NPI assigned
Aug 27, 2021
Last updated
Jun 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Authorized official

Name
Russell Kowalinski, PT, DPTNPI 1083861140
Title
Owner
Phone
(425) 584-7704

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

22443 SE 240TH St Ste 201
Maple Valley, WA 98038-5879

Mailing address

22443 SE 240TH St Ste 201
Maple Valley, WA 98038-5879

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL WebPT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211101001580 WA Part B Supplier - Clinic/Group Practice 8527456185 Receives reassigned benefits from 6 practitioners
Practice locations: Maple Valley, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1700553674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22443 SE 240TH ST STE 201",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22443 SE 240TH ST STE 201",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385879",
            "telephone_number": "425-306-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK SPORTS & SPINE PHYSICAL THERAPY - MAPLE VALLEY PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "KOWALINSKI",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-584-7704",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WebPT",
            "affiliation": "N",
            "address_1": "22443 SE 240th St Ste 201",
            "city": "Maple Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980385879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.