Individual provider Active NPI

Tamara J Shinn, PT

  • Physical Therapist
  • Issaquah, WA
National Provider Identifier
1841229325
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009863 Issued in WA
Practice address
1660 NW Gilman Blvd
Suite 5
Issaquah, WA 98027-5340
Phone
(425) 391-9211
Fax
(425) 391-9545
NPI assigned
Jun 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00009863 WA Primary

Addresses

Primary practice location

1660 NW Gilman Blvd
Suite 5
Issaquah, WA 98027-5340

Mailing address

1660 NW Gilman Blvd
Suite 5
Issaquah, WA 98027-5340
Phone (425) 391-9211

Other identifiers 1

IdentifierTypeStateIssuer
8431686MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102000363 WA Practitioner - Physical Therapist in Private Practice 8426075094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Factoria Sports and Spine Physical Therapy P SGroup PAC ID 9133015415, 7 clinicians

Practice addresses (Care Compare)

13555 SE 36TH St
Suite 101
Bellevue, WA 98006-1485
Phone (425) 653-7100

14100 SE 36TH St
Suite 210
Bellevue, WA 98006-1657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Factoria Sports and Spine Physical Therapy P S Physical Therapist CurrentSince Sep 30, 2021 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy Inc Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

14100 SE 36th St
Ste 210
Bellevue, WA 98006
Phone (425) 653-7100

4411 Point Fosdick Dr
Ste 101
Gig Harbor, WA 98335
Phone (253) 851-7472

1445 NW Mall St
Ste 1
Issaquah, WA 98027
Phone (425) 391-9211

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841229325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 NW GILMAN BLVD",
            "address_2": "SUITE 5",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275340",
            "telephone_number": "425-391-9211",
            "fax_number": "425-391-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 NW GILMAN BLVD",
            "address_2": "SUITE 5",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275340",
            "telephone_number": "425-391-9211",
            "fax_number": "425-391-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINN",
        "first_name": "TAMARA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8431686",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.