NPIMap

Organization Active NPI

One to One Physical Therapy PLLC

  • Physical Therapist
  • Tacoma, WA
National Provider Identifier
1760562995
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00005372 Issued in WA
Legal business name
ONE TO ONE PHYSICAL THERAPY PLLC
Practice address
1807 N Stevens St
Tacoma, WA 98406-3829
Phone
(253) 396-9001
Fax
(253) 396-1231
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Authorized official

Name
Deborah Jean Kristovich, MPT
Title
Owner
Phone
(253) 396-9001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT00005372 WA Primary

Addresses

Primary practice location

1807 N Stevens St
Tacoma, WA 98406-3829

Mailing address

1807 N Stevens St
Tacoma, WA 98406-3829
Phone (253) 396-9001

Other identifiers 2

IdentifierTypeStateIssuer
710935MedicaidWA
1194795997OtherINDIVIDUAL NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317001020 WA Part B Supplier - Clinic/Group Practice 1052201621 Receives reassigned benefits from 6 practitioners
Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory

Locations

1807 N Stevens St
Tacoma, WA 98406
Phone (253) 396-9001

2312 N 30th St
Ste 101
Tacoma, WA 98403
Phone (253) 396-9001

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1760562995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 N STEVENS ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984063829",
            "telephone_number": "253-396-9001",
            "fax_number": "253-396-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 N STEVENS ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984063829",
            "telephone_number": "253-396-9001",
            "fax_number": "253-396-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE TO ONE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "KRISTOVICH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-396-9001",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00005372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710935",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1194795997",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.