Individual provider Active NPI

Michelle Burns

  • Physical Therapist
  • Graham, WA
National Provider Identifier
1710698584
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61606693 Issued in WA
Practice address
10141 224TH St E
Graham, WA 98338-9190
Phone
(253) 446-6982
Fax
(253) 904-8184
NPI assigned
Dec 12, 2022
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 37453 FL
Physical Therapist 225100000X PT61606693 WA Primary

Addresses

Primary practice location

10141 224TH St E
Graham, WA 98338-9190

Mailing address

PO Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other practice location 1

1621 Highway 17 N
North Myrtle Beach, SC 29582-2229
Phone (843) 353-3460

Other names 1

  • Michelle Mack Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120002021 WA Practitioner - Physical Therapist in Private Practice 7911379169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11664SCMDPharmacist
37453FLMDPhysical Therapist
PT61606693WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC CurrentSince Jan 3, 2023 Accepting new patients
Multicare Health System CurrentSince Oct 25, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Oct 25, 2024 Accepting new patients
Orthosc, LLC CurrentSince Jan 3, 2023 Accepting new patients
Orthosc, LLC PastSince May 29, 2022 Accepting new patients

Locations

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

210 Village Center Blvd
Ste 140
Myrtle Beach, SC 29579
Phone (843) 333-8385

1621 Highway 17 N
North Myrtle Beach, SC 29582
Phone (843) 335-3346

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

10141 224th St E
Graham, WA 98338
Phone (253) 240-0315

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1710698584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "address_2": "MS: 820-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10141 224TH ST E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983389190",
            "telephone_number": "253-446-6982",
            "fax_number": "253-904-8184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1621 Highway 17 N",
            "address_purpose": "LOCATION",
            "city": "North Myrtle Beach",
            "state": "SC",
            "postal_code": "295822229",
            "country_code": "US",
            "telephone_number": "843-353-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "37453",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61606693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Graham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.