Individual provider Active NPI

Kennedy Anson

  • Physical Therapist
  • Maple Valley, WA
National Provider Identifier
1982310348
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
22443 SE 240TH St Ste 201
Maple Valley, WA 98038-5879
Phone
(425) 584-7704
NPI assigned
Jan 27, 2023
Last updated
Apr 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 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 NU Primary

Addresses

Primary practice location

22443 SE 240TH St Ste 201
Maple Valley, WA 98038-5879

Mailing address

22443 SE 240TH St Ste 201
Maple Valley, WA 98038-5879
Phone (425) 584-7704

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230327002889 WA Practitioner - Physical Therapist in Private Practice 6507230810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hidef Seattle,LLCGroup PAC ID 1850775917, 22 clinicians

Practice addresses (Care Compare)

15227 SE 283Rd PL
Kent, WA 98042-9414
Phone (206) 692-9929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Sports & Spine Physical Therapy - Maple Valley PS CurrentSince Jan 26, 2023 Accepting new patients
Hidef Seattle,LLC CurrentSince Apr 28, 2024 Accepting new patients
520 Physical Therapy, LLC Physical Therapist PastSince May 16, 2021 Accepting new patients

Locations

15227 SE 283rd Pl
Kent, WA 98042
Phone (206) 692-9929

15423 SE 272nd St
Kent, WA 98042
Phone (206) 693-9929

17709 SE 272nd St
Ste C
Kent, WA 98042
Phone (206) 693-9929

22443 SE 240th St
Ste 201
Maple Valley, WA 98038
Phone (425) 432-1671

2211 5th Ave
Seattle, WA 98121
Phone (206) 693-9929

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1982310348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22443 SE 240TH ST STE 201",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385879",
            "telephone_number": "425-584-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22443 SE 240TH ST STE 201",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385879",
            "telephone_number": "425-584-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSON",
        "first_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.