Individual provider Active NPI

Trent Allen Corey, DPT

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1720210313
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010097 Issued in WA
Practice address
1700 Broadway St Ste 101
Vancouver, WA 98663-3455
Phone
(360) 737-3346
NPI assigned
Aug 14, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 PT00010097 WA Primary

Addresses

Primary practice location

1700 Broadway St Ste 101
Vancouver, WA 98663-3455

Mailing address

1700 Broadway St Ste 101
Vancouver, WA 98663-3455
Phone (360) 737-3346

Other practice location 1

852 Commerce Ave
Longview, WA 98632-2406
Phone (360) 501-3750

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

State licenses

LicenseStateTypeSpecialty
PT00010097WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720210313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 BROADWAY ST STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633455",
            "telephone_number": "360-737-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 BROADWAY ST STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633455",
            "telephone_number": "360-737-3346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "852 Commerce Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322406",
            "country_code": "US",
            "telephone_number": "360-501-3750",
            "fax_number": "360-501-3755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COREY",
        "first_name": "TRENT",
        "middle_name": "ALLEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010097",
            "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 Mar 17, 2018; 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.