INDEPENDENCE REHAB LLC (NPI# 1588043020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588043020 |
| Entity Type | Organization |
| Organization Name | INDEPENDENCE REHAB LLC |
| Practice Address |
919 109th Ave Ne Bellevue WA 98004-4485 |
| Mailing Address |
12123 Ne 172nd Pl M201 Bothell WA 98011-6409 |
| Practice Telephone | 4252338766 |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |
| Authorized Official Name | CHAD FULLMER (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 8014264905 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | LL60391131 | WA | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073536413 | Independence Rehab LLC | Residential Treatment Facility, Physical Disabilities | 5241 Nichols Dr E, Lakeland, FL 33813-4077 | 2006-07-26 |
| 1427184589 | Independence Rehab LLC | Clinic/Center | 3753 Basswood Dr Sw, Grandville, MI 49418-2003 | 2007-02-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Independence Rehab LLC | 5314 N River Run Drive Ste 140, Provo, Utah 84604 |
| Street Address |
919 109TH AVE NE |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-4485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992747729 | Fountains Bellevue Sl, LLC | Skilled Nursing Facility | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2006-06-13 |
| 1538776372 | Meredith Peterson | Occupational Therapist | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2020-09-25 |
| 1235743014 | Dayna J Talley | Occupational Therapist | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2020-08-31 |
| 1528522737 | Courtney Marie Roach | Physical Therapist | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2019-01-22 |
| 1265942874 | Christie L Shin | Speech-Language Pathologist | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2017-10-10 |
| 1487028692 | Jenna Marie Jue | Occupational Therapist | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-11-26 |
| 1083093843 | Shu-min Lin | Occupational Therapist | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-05-27 |
| 1396124384 | Emily Ruth Dosland | Physical Therapist | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-05-22 |
| 1023496114 | Watemark Bellevue, LLC | Skilled Nursing Facility | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-05-11 |
| 1033597059 | Watermark Bellevue, LLC | Skilled Nursing Facility | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861946436 | Bellevue of Cascadia, LLC | Skilled Nursing Facility | 620 N. 6th Street, Bellevue, ID 83313 | 2016-08-11 |
| 1457529950 | Trilogy Healthcare of Bellevue, LLC | Skilled Nursing Facility | 101 Auxiliary Drive, Bellevue, OH 44811-1028 | 2008-02-19 |
| 1740387943 | State of Nebraska Dept of Admin Services | Skilled Nursing Facility | 12505 S 40th St, Bellevue, NE 68123-1868 | 2006-09-20 |
| 1992747729 | Fountains Bellevue Sl, LLC | Skilled Nursing Facility | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2006-06-13 |
| 1255390027 | Riverview Development Corporation | Skilled Nursing Facility | 1201 Park St, Bellevue, IA 52031-1911 | 2006-03-21 |
| 1023496114 | Watemark Bellevue, LLC | Skilled Nursing Facility | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-05-11 |
| 1033597059 | Watermark Bellevue, LLC | Skilled Nursing Facility | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-05-11 |
| 1326390519 | Paragon Rehabilitation | Skilled Nursing Facility | 101 Auxiliary Dr, Bellevue, OH 44811-9492 | 2012-10-11 |
| 1508165226 | Orchard Grove Healthcare Group, LLC | Skilled Nursing Facility | 670 Flat Rock Rd, Bellevue, OH 44811-9486 | 2011-03-21 |
| 1730488685 | Bellevue Healthcare Group, LLC | Skilled Nursing Facility | 1 Audrich Sq, Bellevue, OH 44811-9700 | 2011-03-17 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.