NPIMap

Organization Active NPI

Summit Physical Therapy, Inc.

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1831191832
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00003811 Issued in WA
Legal business name
SUMMIT PHYSICAL THERAPY, INC.
Practice address
830 N Columbia Center Blvd
Suite D
Kennewick, WA 99336-7800
Phone
(509) 783-3444
Fax
(509) 735-7711
NPI assigned
Aug 10, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Phillip George Drussel, P.T.NPI 1114961414
Title
Owner
Phone
(509) 783-3444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00003811 WA Primary

Addresses

Primary practice location

830 N Columbia Center Blvd
Suite D
Kennewick, WA 99336-7800

Mailing address

830 N Columbia Center Blvd
Suite D
Kennewick, WA 99336-7800
Phone (509) 783-3444

Other identifiers 1

IdentifierTypeStateIssuer
7055056MedicaidWA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

830 N Columbia Center Blvd
Ste B1
Kennewick, WA 99336
Phone (509) 783-3444

830 N Columbia Center Blvd
Ste D
Kennewick, WA 99336
Phone (509) 783-3444

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": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831191832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 N COLUMBIA CENTER BLVD",
            "address_2": "SUITE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367800",
            "telephone_number": "509-783-3444",
            "fax_number": "509-735-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N COLUMBIA CENTER BLVD",
            "address_2": "SUITE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367800",
            "telephone_number": "509-783-3444",
            "fax_number": "509-735-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRUSSEL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-783-3444",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7055056",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.