NPIMap

Organization Active NPI

Westside Physical Therapy and Sports Medicine Inc PS

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1821080987
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
600-454-078 Issued in WA
Legal business name
WESTSIDE PHYSICAL THERAPY AND SPORTS MEDICINE INC PS
Practice address
1213 S 40TH Ave
Yakima, WA 98908-3961
Phone
(509) 966-8981
Fax
(509) 966-2125
NPI assigned
Aug 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Authorized official

Name
Mr. John Lawrence Butts, PHYSICAL THERAPISTNPI 1881703908
Title
Owner Director
Phone
(509) 966-8981

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 600-454-078 WA Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 600-454-078 WA

Addresses

Primary practice location

1213 S 40TH Ave
Yakima, WA 98908-3961

Mailing address

1213 S 40TH Ave
Yakima, WA 98908-3961
Phone (509) 966-8981

Other identifiers 2

IdentifierTypeStateIssuer
7682842MedicaidWA
0148298OtherWADEPT OF L & I

National Provider Directory

National Provider Directory

Locations

1213 S 40th Ave
Yakima, WA 98908
Phone (509) 966-8981

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": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325203200000",
    "number": "1821080987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 S 40TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083961",
            "telephone_number": "509-966-8981",
            "fax_number": "509-966-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 S 40TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083961",
            "telephone_number": "509-966-8981",
            "fax_number": "509-966-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PHYSICAL THERAPY AND SPORTS MEDICINE INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-12-30",
        "status": "A",
        "authorized_official_last_name": "BUTTS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER DIRECTOR",
        "authorized_official_telephone_number": "509-966-8981",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "600-454-078",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "600-454-078",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7682842",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L & I",
            "identifier": "0148298",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.