Individual provider Active NPI

Sarah C Robinson Dudley, MPT

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1740335843
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60464065 Issued in WA
Practice address
906 SE Everett Mall Way Ste 200
Everett, WA 98208-3743
Phone
(425) 353-5656
Fax
(425) 513-2807
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 117022 MO
Physical Therapist 225100000X 60464065 WA Primary

Addresses

Primary practice location

906 SE Everett Mall Way Ste 200
Everett, WA 98208-3743

Mailing address

14 E Casino Rd Ste a
Everett, WA 98208-2628
Phone (425) 353-5656

Other identifiers 1

IdentifierTypeStateIssuer
2043563MedicaidWA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
117022MOMDPhysical Therapist
60464065WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Childstrive Physical Therapist CurrentSince Jan 26, 2020 Accepting new patients
Whatcom Center for Early Learning Past Accepting new patients

Locations

906 SE Everett Mall Way
Ste 200
Everett, WA 98208
Phone (425) 353-5656

14 E Casino Rd
Ste A
Everett, WA 98208
Phone (425) 353-5656

Organizations & group practices 2

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1740335843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E CASINO RD STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082628",
            "telephone_number": "425-353-5656",
            "fax_number": "425-513-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 SE EVERETT MALL WAY STE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083743",
            "telephone_number": "425-353-5656",
            "fax_number": "425-513-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON DUDLEY",
        "first_name": "SARAH",
        "middle_name": "C",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "117022",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60464065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2043563",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.