Individual provider Active NPI

Kristine L Regis, PT

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1710028980
Registry record updated Aug 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006449 Issued in WA
Practice address
3726 Broadway
Suite 104
Everett, WA 98201-5030
Phone
(425) 252-4600
Fax
(425) 252-4477
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00006449 WA Primary

Addresses

Primary practice location

3726 Broadway
Suite 104
Everett, WA 98201-5030

Mailing address

11805 N Creek Pkwy S
Ste 113
Bothell, WA 98011-8803
Phone (425) 806-5700

Other identifiers 1

IdentifierTypeStateIssuer
8376436MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Rehabilitation Associates, PLLC Physical Therapist Past Accepting new patients
Summit Rehabilitation PLLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250899200000",
    "number": "1710028980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11805 N CREEK PKWY S",
            "address_2": "STE 113",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118803",
            "telephone_number": "425-806-5700",
            "fax_number": "425-806-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY",
            "address_2": "SUITE 104",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982015030",
            "telephone_number": "425-252-4600",
            "fax_number": "425-252-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIS",
        "first_name": "KRISTINE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8376436",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2009; 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.