Individual provider Active NPI

Grace Bird Ellison, G.P.T.

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1902060197
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1519 132ND St SE
Suite a
Everett, WA 98208-7203
Phone
(425) 337-9556
Fax
(425) 357-9186
NPI assigned
Jul 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1519 132ND St SE
Suite a
Everett, WA 98208-7203

Mailing address

1519 132ND St SE
Suite a
Everett, WA 98208-7203
Phone (425) 337-9556

Other identifiers 16

IdentifierTypeStateIssuer
8948510OtherWAL&I CRIME
0273751OtherWADEPT OF L&I
1020BIOtherWAREGENCE
P00738996OtherWARAILROAD MEDICARE IRG
1170BIOtherWAREGENCE
2060BIOtherWAREGENCE
8522666OtherWADSHS
P00664566OtherWARAILROAD MEDICARE
239386OtherWAL&I
4030BIOtherWAREGENCE
6097BIOtherWAREGENCE
239347OtherWAL&I
2588BIOtherWAREGENCE
0157BIOtherWAREGENCE
5029BIOtherWAREGENCE
8948544OtherWAL&I CRIME

Other names 1

  • Shannon Grace Bird Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080930000086 WA Practitioner - Physical Therapist in Private Practice 8123195336 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Miami, LM Miller School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehabilitation Group PCGroup PAC ID 0042111718, 192 clinicians

Practice addresses (Care Compare)

10207 19TH Ave SE
Everett, WA 98208-4257
Phone (425) 337-3166

7315 212TH St SW
Edmonds, WA 98026-7610
Phone (425) 673-2673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Everett Physical Therapy and Sport Performance Center PLLC Physical Therapist CurrentSince Feb 1, 2011 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Aug 19, 2008 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC CurrentSince Feb 1, 2011 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Aug 19, 2008 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Aug 19, 2008 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Aug 19, 2008 Accepting new patients

Locations

300 W Clarendon Ave
Ste 285
Phoenix, AZ 85013
Phone (602) 277-3686

1300 W Sam Houston Pkwy S
Ste 300
Houston, TX 77042
Phone (713) 297-7052

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

22910 Bothell Everett Hwy
Ste 107
Bothell, WA 98021
Phone (425) 686-7656

1519 132nd St SE
Ste A
Everett, WA 98208
Phone (425) 337-9556

2000 Hewitt Ave
Ste 115
Everett, WA 98201
Phone (425) 252-3908

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

1830 Bickford Ave
Ste 209
Snohomish, WA 98290
Phone (360) 568-7774

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1902060197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 132ND ST SE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982087203",
            "telephone_number": "425-337-9556",
            "fax_number": "425-357-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 132ND ST SE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982087203",
            "telephone_number": "425-337-9556",
            "fax_number": "425-357-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "GRACE",
        "middle_name": "BIRD",
        "credential": "G.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME",
            "identifier": "8948510",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L&I",
            "identifier": "0273751",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1020BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE IRG",
            "identifier": "P00738996",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1170BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "2060BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "8522666",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00664566",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "239386",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "4030BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "6097BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "239347",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "2588BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "0157BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5029BI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME",
            "identifier": "8948544",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BIRD",
            "middle_name": "GRACE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.