NPIMap

Organization Active NPI

Bridle Trails Physical Therapy

  • Physical Therapist
  • Redmond, WA
National Provider Identifier
1720460710
Registry record updated Feb 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BRIDLE TRAILS PHYSICAL THERAPY
Practice address
13200 Old Redmond Rd Ste 140
Redmond, WA 98052-1819
Phone
(425) 889-0776
Fax
(425) 889-0857
NPI assigned
Jun 25, 2015
Last updated
Feb 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2021

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

Authorized official

Name
Cole MonsonNPI 1174834543
Title
Owner
Phone
(425) 889-0776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

13200 Old Redmond Rd Ste 140
Redmond, WA 98052-1819

Mailing address

13200 Old Redmond Rd Ste 140
Redmond, WA 98052-1819
Phone (425) 889-0776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160304000247 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678879400 Receives reassigned benefits from 1 practitioner
Practice locations: Redmond, WA

National Provider Directory

National Provider Directory

Locations

13200 Old Redmond Rd
Ste 140
Redmond, WA 98052
Phone (425) 889-0776

Practitioners & affiliated clinicians

Practitioners 10

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": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612569600000",
    "number": "1720460710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13200 OLD REDMOND RD STE 140",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521819",
            "telephone_number": "425-889-0776",
            "fax_number": "425-889-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13200 OLD REDMOND RD STE 140",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521819",
            "telephone_number": "425-889-0776",
            "fax_number": "425-889-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDLE TRAILS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2021-02-06",
        "certification_date": "2021-02-06",
        "status": "A",
        "authorized_official_last_name": "MONSON",
        "authorized_official_first_name": "COLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-889-0776"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.