NPIMap

Organization Active NPI

Rebound Physical Therapy

  • Athletic Trainer
  • Vancouver, WA
National Provider Identifier
1720040397
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-AT-707950 Issued in OR
Legal business name
REBOUND PHYSICAL THERAPY
Practice address
200 NE Mother Joseph PL
Suite G100
Vancouver, WA 98664-3299
Phone
(360) 514-2048
Fax
(360) 514-3155
NPI assigned
Apr 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Brady W Corse, A.T.CNPI 1275809709
Title
Athletic Trainer
Phone
(360) 514-2048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X AT-AT-707950 OR Primary

Addresses

Primary practice location

200 NE Mother Joseph PL
Suite G100
Vancouver, WA 98664-3299

Mailing address

11610 NW 27TH Court
Vancouver, WA 98685

National Provider Directory

National Provider Directory

Locations

200 NE Mother Joseph Pl
Ste G100
Vancouver, WA 98664
Phone (360) 514-2048

Practitioners & affiliated clinicians

Practitioners 1

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": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720040397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11610 NW 27TH COURT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE G100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-514-2048",
            "fax_number": "360-514-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBOUND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORSE",
        "authorized_official_first_name": "BRADY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ATHLETIC TRAINER",
        "authorized_official_telephone_number": "360-514-2048",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "A.T.C"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-707950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.