Individual provider Active NPI

Stefanie Elizabeth Jemison

  • Physical Therapist
  • Federal Way, WA
National Provider Identifier
1720628811
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60994976 Issued in WA
Practice address
32030 23Rd Ave S
Federal Way, WA 98003-6031
Phone
(253) 216-2344
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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 PT60994976 WA Primary

Addresses

Primary practice location

32030 23Rd Ave S
Federal Way, WA 98003-6031

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

7721 44th Ave SW
Seattle, WA 98136-2205
Phone (504) 236-1065

Other practice location 2

427 9th St
San Antonio, TX 78215-1528
Phone (210) 951-3280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200519001566 WA Practitioner - Physical Therapist in Private Practice 1759712110 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back to Work Prevention and Physical Therapy IncGroup PAC ID 0446444624, 26 clinicians

Practice addresses (Care Compare)

4351 15TH Ave S
Suite 102
Seattle, WA 98108-1474
Phone (206) 649-5110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle'S Elite Physical Therapy P.S. Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Feb 13, 2020 Accepting new patients
Back to Work Prevention & Physical Therapy, Inc. CurrentSince Nov 22, 2023 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Feb 13, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

5620 Rainier Ave S
Ste 102
Seattle, WA 98118
Phone (206) 535-8061

1521 Queen Anne Ave N
Seattle, WA 98109
Phone (206) 946-6655

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1720628811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32030 23RD AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036031",
            "telephone_number": "253-216-2344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7721 44th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981362205",
            "country_code": "US",
            "telephone_number": "504-236-1065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "427 9th St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782151528",
            "country_code": "US",
            "telephone_number": "210-951-3280",
            "fax_number": "210-858-9220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEMISON",
        "first_name": "STEFANIE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60994976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.