Active NPI
Rebecca Nicole Anderson, DPT
- Physical Therapist
- Kent, WA
National Provider Identifier
1902473150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60750308
- Practice address
- 516 Kenosia Ave S
Kent, WA 98030-5909 - Phone
- (253) 216-0949
- Fax
- (617) 420-4141
- NPI assigned
- Jun 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60750308 | WA | Primary |
Addresses
Primary practice location
516 Kenosia Ave S
Kent, WA 98030-5909
Mailing address
516 Kenosia Ave S
Kent, WA 98030-5909
Phone (253) 216-0949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT60750308 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1902473150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 KENOSIA AVE S",
"city": "KENT",
"state": "WA",
"postal_code": "980305909",
"telephone_number": "253-216-0949",
"fax_number": "617-420-4141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 KENOSIA AVE S",
"city": "KENT",
"state": "WA",
"postal_code": "980305909",
"telephone_number": "253-216-0949",
"fax_number": "617-420-4141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "REBECCA",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-07",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60750308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.