NPIMap

Organization Active NPI

Optimum Physical Therapy, LLC

  • Physical Therapist
  • Fircrest, WA
National Provider Identifier
1972812675
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008775 Issued in WA
Legal business name
OPTIMUM PHYSICAL THERAPY, LLC
Practice address
1027 Regents Blvd
Fircrest, WA 98466-6030
Phone
(253) 202-6858
NPI assigned
Sep 28, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Shannon Zook, PTNPI 1013956184
Title
Owner/Ceo
Phone
(253) 202-6858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110122000072 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1557540531 Receives reassigned benefits from 4 practitioners
Practice locations: Fircrest, WA

National Provider Directory

National Provider Directory

Locations

1027 Regents Blvd
Fircrest, WA 98466
Phone (253) 202-6858

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT00008775 WA Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT00009243 WA

Addresses

NPPES NPI Registry

Primary practice location

1027 Regents Blvd
Fircrest, WA 98466-6030

Mailing address

1027 Regents Blvd
Fircrest, WA 98466-6030
Phone (253) 202-6858

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 29, 2010.

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1972812675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 REGENTS BLVD",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666030",
            "telephone_number": "253-202-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 REGENTS BLVD",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666030",
            "telephone_number": "253-202-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "ZOOK",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "253-202-6858",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008775",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fircrest, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.