Active NPI
Charmaine R Minnis, PT
- Physical Therapist
- Chelan, WA
National Provider Identifier
1912988924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 025208 PT00006114
- Practice address
- 123 E Johnson Ave
Chelan, WA 98816 - Phone
- (509) 682-4713
- Fax
- (509) 682-3218
- NPI assigned
- Nov 7, 2005
- 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 | 025208 PT00006114 | WA | Primary |
Addresses
Primary practice location
123 E Johnson Ave
Chelan, WA 98816
Mailing address
PO Box 6
Chelan, WA 98816-0006
Phone (509) 682-4713
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8335622 | Medicaid | WA | |
| 161721 | Other | WA | PERSONAL L&I ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025208 PT00006114 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1912988924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6",
"city": "CHELAN",
"state": "WA",
"postal_code": "988160006",
"telephone_number": "509-682-4713",
"fax_number": "509-682-3218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 E JOHNSON AVE",
"city": "CHELAN",
"state": "WA",
"postal_code": "98816",
"telephone_number": "509-682-4713",
"fax_number": "509-682-3218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINNIS",
"first_name": "CHARMAINE",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-07",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "025208 PT00006114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8335622",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL L&I ID",
"identifier": "161721",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chelan, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.