Active NPI
Thomas Bucklew, P.T.
- Physical Therapist
- Colville, WA
National Provider Identifier
1922035013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00005453
- Practice address
- 143 Garden Homes Dr
Colville, WA 99114-9229 - Phone
- (509) 685-5888
- Fax
- (509) 685-2172
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 23460 | CA | |
| Physical Therapist | 225100000X | 00005453 | WA | Primary |
Addresses
Primary practice location
143 Garden Homes Dr
Colville, WA 99114-9229
Mailing address
820 S. Meyers
Kettle Falls, WA 99141
Phone (209) 329-4093
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 |
|---|---|---|---|
| 00005453 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922035013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 S. MEYERS",
"city": "KETTLE FALLS",
"state": "WA",
"postal_code": "99141",
"telephone_number": "209-329-4093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 GARDEN HOMES DR",
"city": "COLVILLE",
"state": "WA",
"postal_code": "991149229",
"telephone_number": "509-685-5888",
"fax_number": "509-685-2172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEW",
"first_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "23460",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "00005453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.