NPIMap

Organization Active NPI

Ret Sunrise Physical Therapy, PLLC

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1942641147
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RET SUNRISE PHYSICAL THERAPY, PLLC
Practice address
17528 Meridian E Ste 205
Puyallup, WA 98375-6286
Phone
(253) 256-4807
Fax
(253) 256-4809
NPI assigned
Jul 16, 2013
Last updated
Dec 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Dwan Diaz
Title
Credentialing Coordinator
Phone
(813) 560-8157

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

17528 Meridian E Ste 205
Puyallup, WA 98375-6286

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (813) 560-8157

Other names 3

  • RET Sunrise Physical Therapy PLLC Former legal business name
  • RET Physical Therapy & Healthcare Specialists Other name
  • Sunrise Physical Therapy Other name

National Provider Directory

National Provider Directory
Tax ID family
Therapy Management Services PLLC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

17528 Meridian E
Ste 209
Puyallup, WA 98375
Phone (253) 445-8530

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1942641147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "813-560-8157",
            "fax_number": "425-452-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17528 MERIDIAN E STE 205",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756286",
            "telephone_number": "253-256-4807",
            "fax_number": "253-256-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RET SUNRISE PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-16",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "DWAN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "813-560-8157"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RET Sunrise Physical Therapy PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "RET Physical Therapy & Healthcare Specialists",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sunrise Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.