Sportsmed Physical Therapy, Inc., P.S.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPORTSMED PHYSICAL THERAPY, INC., P.S.

Practice address

463 Tremont Street W.
Suite 102
Port Orchard, WA 98366-0000

Phone

(360) 895-1160

Fax

(360) 895-1161

NPI assigned

Feb 23, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Adam Blake Kershaw, P.T., M.P.T., O.C.S

Title

Owner / Physical Therapist

Phone

(801) 455-7329

Specialties & licenses 1

Addresses

Other names 1

• SportsMed Physical Therapy Doing business as

Locations

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1881834448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11009",
            "address_2": "CASCADE BILLING",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985081009",
            "telephone_number": "360-352-2037",
            "fax_number": "360-352-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 TREMONT STREET W.",
            "address_2": "SUITE 102",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983660000",
            "telephone_number": "360-895-1160",
            "fax_number": "360-895-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTSMED PHYSICAL THERAPY, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "KERSHAW",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER / PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "801-455-7329",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T., M.P.T., O.C.S"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SportsMed Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.