NPIMap

Organization Active NPI

Penrose & Associates Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Lacey, WA
National Provider Identifier
1740480110
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT00008404 Issued in WA
Legal business name
PENROSE & ASSOCIATES PHYSICAL THERAPY LLC
Practice address
1445 Galaxy Dr NE
Suite 301
Lacey, WA 98516-4746
Phone
(360) 456-1444
Fax
(360) 456-1883
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Authorized official

Name
Mrs. Jennifer Erin Penrose, PTNPI 1881696805
Title
Clinic Director/Owner
Phone
(360) 456-1444

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 Therapy Clinic/Center 261QP2000X PT00008404 WA Primary

Addresses

Primary practice location

1445 Galaxy Dr NE
Suite 301
Lacey, WA 98516-4746

Mailing address

1445 Galaxy Dr NE
Suite 301
Lacey, WA 98516-4746
Phone (360) 456-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070823000833 WA Part B Supplier - Clinic/Group Practice 1052403896 Receives reassigned benefits from 15 practitioners
Practice locations: Lacey, WA

National Provider Directory

National Provider Directory

Locations

1445 Galaxy Dr NE
Ste 301
Lacey, WA 98516
Phone (360) 456-1444

1445 Galaxy Dr NE
Lacey, WA 98516
Phone (360) 456-1444

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1740480110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 GALAXY DR NE",
            "address_2": "SUITE 301",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164746",
            "telephone_number": "360-456-1444",
            "fax_number": "360-456-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 GALAXY DR NE",
            "address_2": "SUITE 301",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164746",
            "telephone_number": "360-456-1444",
            "fax_number": "360-456-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENROSE & ASSOCIATES PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "PENROSE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ERIN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR/OWNER",
        "authorized_official_telephone_number": "360-456-1444",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT00008404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.