Individual provider Active NPI

Daisy Jo Fish, DPT

  • Physical Therapist
  • Kent, WA
National Provider Identifier
1760823124
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60791853 Issued in WA
Practice address
13215 SE 240TH St Ste D
Kent, WA 98042-5120
Phone
(253) 631-3026
Fax
(253) 631-3899
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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 PT60791853 WA Primary

Addresses

Primary practice location

13215 SE 240TH St Ste D
Kent, WA 98042-5120

Mailing address

PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171011003835 WA Practitioner - Physical Therapist in Private Practice 5193959088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Motion Physical Therapy, Inc., PSGroup PAC ID 9638162993, 9 clinicians

Practice addresses (Care Compare)

9419 Coppertop Loop NE
Bainbridge Island, WA 98110-3647
Phone (206) 842-2428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60791853WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Motion Physical Therapy, Inc., PS Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist PastSince Oct 11, 2017 Accepting new patients

Locations

9419 Coppertop Loop NE
Bainbridge Island, WA 98110
Phone (206) 842-2428

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1760823124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-309-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13215 SE 240TH ST STE D",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980425120",
            "telephone_number": "253-631-3026",
            "fax_number": "253-631-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "DAISY",
        "middle_name": "JO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60791853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.