Individual provider Active NPI

Kody Allen Brandt, DPT

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1922564293
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60920832 Issued in WA
Practice address
201 E Yakima Ave Ste 101
Yakima, WA 98901-2627
Phone
(509) 540-3244
Fax
(509) 219-6002
NPI assigned
Feb 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60920832 WA Primary

Addresses

Primary practice location

201 E Yakima Ave Ste 101
Yakima, WA 98901-2627

Mailing address

201 E Yakima Ave Ste 101
Yakima, WA 98901-2627
Phone (509) 540-3244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190308002307 WA Practitioner - Physical Therapist in Private Practice 4284973256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Arc Physical Therapy and Wellness LLCGroup PAC ID 2365885076, 2 clinicians

Practice addresses (Care Compare)

2614 W Nob Hill Blvd
Suite a
Yakima, WA 98902-7506
Phone (509) 480-8041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60920832WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Sports and Spine Physical Therapist CurrentSince Feb 12, 2019 Accepting new patients
Arc Physical Therapy & Wellness LLC Physical Therapist CurrentSince Jun 17, 2024 Accepting new patients
RPM Rehab, Inc Physical Therapist PastSince Feb 12, 2019 Accepting new patients

Locations

2614 W Nob Hill Blvd
Ste A
Yakima, WA 98902
Phone (509) 480-8041

2505 Racquet Ln
Yakima, WA 98902
Phone (509) 453-7325

201 E Yakima Ave
Ste 101
Yakima, WA 98901
Phone (509) 540-3244

201 E Yakima Ave
Yakima, WA 98901
Phone (509) 480-8041

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1922564293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E YAKIMA AVE STE 101",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012627",
            "telephone_number": "509-540-3244",
            "fax_number": "509-219-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E YAKIMA AVE STE 101",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012627",
            "telephone_number": "509-540-3244",
            "fax_number": "509-219-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "KODY",
        "middle_name": "ALLEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60920832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.