Stargait Medford Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

STARGAIT MEDFORD PHYSICAL THERAPY, LLC

Practice address

16420 SE McGillivray Blvd Ste 103-355
Vancouver, WA 98683-3461

Phone

(541) 292-4244

Fax

(855) 840-8203

NPI assigned

Feb 21, 2020

Last updated

Feb 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Denise A Wentzel, PTNPI 1063798726

Title

Owner

Phone

(541) 292-4244

Specialties & licenses 6

Addresses

Locations

Practitioners 1

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.

• Denise A Wentzel, PT

  • Physical Therapist
  • Vancouver, WA
  • NPI 1063798726
  Authorized official Same address or phone

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1841824471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16420 SE MCGILLIVRAY BLVD STE 103-355",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833461",
            "telephone_number": "541-292-4244",
            "fax_number": "855-840-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16420 SE MCGILLIVRAY BLVD STE 103-355",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833461",
            "telephone_number": "541-292-4244",
            "fax_number": "855-840-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARGAIT MEDFORD PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "WENTZEL",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-292-4244",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224ZF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J. Stanton, RPH
• Vayda Marie Stapleton, LMP
• Star Meadow Counseling, PLLC
• Stardig Nursing Services PLLC
• Erika Rae Stardig, RN
• Stargait Physical Therapy
• Geraldine M Stark, MD
• Roger W Stark, RC
• Gunnar Starke, PT, DPT
• Brittney Starkey, M.MFT, LMFT

• Physical Therapist in Vancouver, WA
• Providers in Vancouver, 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 21, 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.