Mark A Whitley, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00002835 Issued in WA

Practice address

23806 E Broadway Ave
Liberty Lake, WA 99019-9665

Phone

(509) 868-7202

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Inland Physical Therapy and Sports Rehab

  • Physical Therapist
  • Spokane Valley, WA
  • NPI 1407933609
  NPD (past)
• San Luis Physical Therapy & Orthopedic Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Atascadero, CA
  • NPI 1225046824

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1720165913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23806 E BROADWAY AVE",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990199665",
            "telephone_number": "509-868-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23806 E BROADWAY AVE",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990199665",
            "telephone_number": "509-868-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8345217",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720165913",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coleen Watkins
• Alden Robert Webb, D.O.
• Well Life Compounding LLC
• Dashiel Wham, NP
• Kimberly S White, D.C.
• Jennifer Rebecca Wilde
• Wildecare Education
• Clint Wire, DDS, MS
• Jeffrey A Wirthlin, MD
• Wishblow Speech Therapy

• All providers in Liberty Lake, WA
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.