NPIMap

Organization Active NPI

Anderson Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Kennewick, WA
National Provider Identifier
1881921054
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
602930410 Issued in WA
Legal business name
ANDERSON PHYSICAL THERAPY, LLC
Practice address
512 N Young St Ste C
Kennewick, WA 99336-7839
Phone
(509) 736-2225
Fax
(509) 736-3366
NPI assigned
Nov 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Mr. Trevor S Anderson, PTNPI 1689756769
Title
Owner
Phone
(509) 736-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 602930410 WA Primary

Addresses

Primary practice location

512 N Young St Ste C
Kennewick, WA 99336-7839

Mailing address

PO Box 4764
West Richland, WA 99353-4012
Phone (509) 528-3308

Other practice location 1

3603 W Court St
Pasco, WA 99301-2709
Phone (509) 412-1086

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100208000702 WA Part B Supplier - Clinic/Group Practice 4981747219 Receives reassigned benefits from 7 practitioners
Practice locations: Kennewick, WA; Pasco, WA; Sunnyside, WA

National Provider Directory

National Provider Directory

Locations

5221 W Canal Dr
Kennewick, WA 99336
Phone (509) 528-3308

3835 W Court St
Ste 4C
Pasco, WA 99301
Phone (509) 412-1085

Practitioners & affiliated clinicians

Practitioners 8

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": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1881921054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4764",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993534012",
            "telephone_number": "509-528-3308",
            "fax_number": "509-736-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N YOUNG ST STE C",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367839",
            "telephone_number": "509-736-2225",
            "fax_number": "509-736-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3603 W Court St",
            "address_purpose": "LOCATION",
            "city": "Pasco",
            "state": "WA",
            "postal_code": "993012709",
            "country_code": "US",
            "telephone_number": "509-412-1086",
            "fax_number": "509-736-3366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDERSON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-736-2225",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "602930410",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 7, 2020; 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.