NPIMap

Organization Active NPI

Impact Physical Therapy, P.S.

  • Physical Therapist
  • Lynnwood, WA
National Provider Identifier
1922178201
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008381 Issued in WA
Legal business name
IMPACT PHYSICAL THERAPY, P.S.
Practice address
6101 200TH St SW Ste 208
Lynnwood, WA 98036-6077
Phone
(425) 778-2325
Fax
(425) 778-7692
NPI assigned
Nov 8, 2006
Last updated
Jul 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Ms. Nancy MitranoNPI 1003996562
Title
Owner-Impact Physical Therapy, P.S.
Phone
(425) 778-2325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT00008381 WA Primary

Addresses

Primary practice location

6101 200TH St SW Ste 208
Lynnwood, WA 98036-6077

Mailing address

6101 200TH St SW Ste 208
Lynnwood, WA 98036-6077
Phone (425) 778-2325

National Provider Directory

National Provider Directory

Locations

4610 200th St SW
Ste D
Lynnwood, WA 98036
Phone (425) 697-5583

4630 200th St SW
Ste D
Lynnwood, WA 98036
Phone (425) 697-5583

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1922178201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 200TH ST SW STE 208",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366077",
            "telephone_number": "425-778-2325",
            "fax_number": "425-778-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 200TH ST SW STE 208",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366077",
            "telephone_number": "425-778-2325",
            "fax_number": "425-778-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICAL THERAPY, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "MITRANO",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OWNER-IMPACT PHYSICAL THERAPY, P.S.",
        "authorized_official_telephone_number": "425-778-2325",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.