Charles M Depner, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00006099 Issued in WA

Practice address

12012 E Mission Ave
Spokane Valley, WA 99206-4887

Phone

(509) 413-1630

NPI assigned

Aug 4, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Healthcare Inc.Group PAC ID 7517857899, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Synergy Healthcare Inc.

  • Physical Therapist
  • Spokane Valley, WA
  • NPI 1780741439
  Medicare reassignment Care Compare group NPD
• Select Physical Therapy Orthopedic Services, Inc.

  • Rehabilitation Clinic/Center
  • Chicago, IL
  • NPI 1881180636
  NPD (past)

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1790916088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 E 28TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033217",
            "telephone_number": "509-624-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12012 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064887",
            "telephone_number": "509-413-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPNER",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8333932",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha Vanessa Demattos, M.D.
• Dementia Care Solutions
• Tyler Denbleyker
• Hayley Denison, DDS
• Dental Care Associates of Spokane Valley
• Teresa Mae Depoe
• Kendall Nicole Deremer
• Britny Derton
• Monique Marie Deschane, MA
• Joseph Michael Destaven Jr.

• Physical Therapist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.