Organization Active NPI

Burlington Physical Therapy, LLC

  • Physical Therapist
  • Burlington, WA
National Provider Identifier
1881674497
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BURLINGTON PHYSICAL THERAPY, LLC
Practice address
1186 S Burlington Blvd
Burlington, WA 98233-3314
Phone
(360) 757-9018
Fax
(360) 757-9019
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Authorized official

Name
Mrs. Michelle L King
Title
Billing Manager
Phone
(360) 757-9018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X WA Primary

Addresses

Primary practice location

1186 S Burlington Blvd
Burlington, WA 98233-3314

Mailing address

1186 South Burlington Blvd
Burlington, WA 98233
Phone (360) 757-9018

Other identifiers 1

IdentifierTypeStateIssuer
7128929MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050914001425 WA Part B Supplier - Clinic/Group Practice 2466485933 Receives reassigned benefits from 3 practitioners
Practice locations: Burlington, WA

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1186 S Burlington Blvd
Burlington, WA 98233
Phone (360) 757-9018

Practitioners & affiliated clinicians

Practitioners 6

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": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1881674497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 SOUTH BURLINGTON BLVD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "98233",
            "telephone_number": "360-757-9018",
            "fax_number": "360-757-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1186 S BURLINGTON BLVD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333314",
            "telephone_number": "360-757-9018",
            "fax_number": "360-757-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLINGTON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "360-757-9018",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7128929",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.