Active NPI
Carla Pedey, LMT
- Physical Therapist
- Fircrest, WA
National Provider Identifier
1770018376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- MA00012503
- Practice address
- 4040 Orchard St W
Suite 100
Fircrest, WA 98466-6606 - Phone
- (951) 696-9353
- Fax
- (951) 973-7216
- NPI assigned
- Apr 21, 2017
- Last updated
- Apr 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | MA00012503 | WA | Primary |
Addresses
Primary practice location
4040 Orchard St W
Suite 100
Fircrest, WA 98466-6606
Mailing address
4040 Orchard St W
Suite 100
Fircrest, WA 98466-6606
Phone (951) 696-9353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA00012503 | Other | WA | LMT LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00012503 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492732800000",
"number": "1770018376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 ORCHARD ST W",
"address_2": "SUITE 100",
"city": "FIRCREST",
"state": "WA",
"postal_code": "984666606",
"telephone_number": "951-696-9353",
"fax_number": "951-973-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4040 ORCHARD ST W",
"address_2": "SUITE 100",
"city": "FIRCREST",
"state": "WA",
"postal_code": "984666606",
"telephone_number": "951-696-9353",
"fax_number": "951-973-7216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDEY",
"first_name": "CARLA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-21",
"last_updated": "2017-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "MA00012503",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMT LICENSE",
"identifier": "MA00012503",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fircrest, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.