Individual provider Active NPI

Krista Marie Ernsdorf, P.T.

  • Orthopedic Physical Therapist
  • Vancouver, WA
National Provider Identifier
1891944815
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
60201103 Issued in WA
Practice address
1700 Broadway St
Suite 101
Vancouver, WA 98663-3455
Phone
(360) 737-3346
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 60201103 WA Primary

Addresses

Primary practice location

1700 Broadway St
Suite 101
Vancouver, WA 98663-3455

Mailing address

1700 Broadway St
Suite 101
Vancouver, WA 98663-3455
Phone (360) 737-3346

Other identifiers 3

IdentifierTypeStateIssuer
0239973OtherORWASHINGTON L & I
500606411MedicaidOR
P00802452OtherORRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130429000400 WA Practitioner - Physical Therapist in Private Practice 8022186105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sole Sisters Physical Therapy LLCGroup PAC ID 2466604640, 4 clinicians

Practice addresses (Care Compare)

2312 W Main St
Suite 117
Battle Ground, WA 98604-4233
Phone (360) 687-7147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60201103WAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sole Sisters Physical Therapy, LLC Orthopedic CurrentSince Feb 13, 2023 Accepting new patients
Movement Systems Physical Therapy, P.S. CurrentSince Jan 1, 2023 Accepting new patients
Therapeutic Associates Inc Past Accepting new patients
Anunciado Enterprises PC PastSince Sep 25, 2015 Accepting new patients

Locations

1100 Circle 75 Pkwy SE
Ste 1400
Atlanta, GA 30339
Phone (678) 403-3555

2312 W Main St
Ste 117
Battle Ground, WA 98604
Phone (360) 608-3883

8435 SE 68th St
Ste 100
Mercer Island, WA 98040
Phone (206) 405-1864

1200 Westlake Ave N
Ste 100
Seattle, WA 98109
Phone (206) 405-1864

1700 Broadway St
Ste 101
Vancouver, WA 98663
Phone (360) 737-3346

Organizations & group practices 4

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1891944815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 BROADWAY ST",
            "address_2": "SUITE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633455",
            "telephone_number": "360-737-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 BROADWAY ST",
            "address_2": "SUITE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633455",
            "telephone_number": "360-737-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNSDORF",
        "first_name": "KRISTA",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "60201103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L & I",
            "identifier": "0239973",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500606411",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00802452",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.