Individual provider Active NPI

Jordan Sasiela, DPT

  • Physical Therapist
  • Port Orchard, WA
National Provider Identifier
1952945024
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60967216 Issued in WA
Practice address
2689 Hoover Ave SE
Port Orchard, WA 98366-3013
Phone
(360) 874-7000
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2017003438 MO
Physical Therapist 225100000X PT60967216 WA Primary

Addresses

Primary practice location

2689 Hoover Ave SE
Port Orchard, WA 98366-3013

Mailing address

3105 Country Knoll Dr
Saint Charles, MO 63303-6342
Phone (636) 696-6888

Other names 1

  • Jordan Beck Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://xeponline.wa-k12.net

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2017003438MOMDPhysical Therapist
PT60967216WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1952945024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 COUNTRY KNOLL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036342",
            "telephone_number": "636-696-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2689 HOOVER AVE SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663013",
            "telephone_number": "360-874-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASIELA",
        "first_name": "JORDAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2017003438",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60967216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://xeponline.wa-k12.net",
            "affiliation": "N",
            "address_1": "2689 Hoover Ave SE",
            "city": "Port Orchard",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983663013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "BECK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.