Individual provider Active NPI

Jeff Fjelstul, MOMT,PT, ATC, CSCS

  • Orthopedic Physical Therapist
  • Seattle, WA
National Provider Identifier
1912929902
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT00003551 Issued in WA
Practice address
1660 S Columbian Way
VA Puget Sound Healthcare System
Seattle, WA 98108-1532
Phone
(206) 764-2202
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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 PT00003551 WA Primary

Addresses

Primary practice location

1660 S Columbian Way
VA Puget Sound Healthcare System
Seattle, WA 98108-1532

Mailing address

1660 S Columbian Way
VA Puget Sound Healthcare System
Seattle, WA 98108-1532

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

LicenseStateTypeSpecialty
PT00003551WAMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1912929902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "address_2": "VA PUGET SOUND HEALTHCARE SYSTEM",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "address_2": "VA PUGET SOUND HEALTHCARE SYSTEM",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-764-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FJELSTUL",
        "first_name": "JEFF",
        "credential": "MOMT,PT, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT00003551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.