NPIMap

Organization Active NPI

Blanchard Mountain Physical Therapy PLLC

  • Physical Therapist
  • Mount Vernon, WA
National Provider Identifier
1801642871
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BLANCHARD MOUNTAIN PHYSICAL THERAPY PLLC
Practice address
2226 Market St Ste C
Mount Vernon, WA 98273-5451
Phone
(360) 840-2472
NPI assigned
Apr 29, 2024
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Jason Richard Smith, DPTNPI 1902273394
Title
Physical Therapist/Part Owner
Phone
(360) 840-2387

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2226 Market St Ste C
Mount Vernon, WA 98273-5451

Mailing address

PO Box 171
Mount Vernon, WA 98273-0171
Phone (360) 840-2472

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240801000963 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890232441 Receives reassigned benefits from 3 practitioners
Practice locations: Mount Vernon, WA

National Provider Directory

National Provider Directory

Locations

2226 Market St
Ste C
Mount Vernon, WA 98273
Phone (360) 428-6677

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1801642871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982730171",
            "telephone_number": "360-840-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 MARKET ST STE C",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735451",
            "telephone_number": "360-840-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANCHARD MOUNTAIN PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/PART OWNER",
        "authorized_official_telephone_number": "360-840-2387",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.