NPIMap

Organization Active NPI

North Lake Physical Therapy and Rehabilitation, Inc.

  • Physical Therapist
  • Milwaukie, OR
National Provider Identifier
1003183302
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.
Practice address
4606 SE Boardman Ave
Milwaukie, OR 97267-5930
Phone
(503) 353-9776
Fax
(503) 353-9777
NPI assigned
Nov 30, 2011
Last updated
Nov 30, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Michael Choate, MSPTNPI 1972571511
Title
President, North Lake Physical Ther
Phone
(503) 636-3028

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4606 SE Boardman Ave
Milwaukie, OR 97267-5930

Mailing address

101 S State St Ste 200G
Lake Oswego, OR 97034-3900
Phone (503) 636-3028

Other names 1

  • Kosta, Choate and Pierson, Inc. Former legal business name

National Provider Directory

National Provider Directory
Part of
North Lake Phys Therapy

Locations

4606 SE Boardman Ave
Portland, OR 97267
Phone (503) 353-9776

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1003183302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S STATE ST STE 200G",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343900",
            "telephone_number": "503-636-3028",
            "fax_number": "503-636-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 SE BOARDMAN AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972675930",
            "telephone_number": "503-353-9776",
            "fax_number": "503-353-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "CHOATE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT, NORTH LAKE PHYSICAL THER",
        "authorized_official_telephone_number": "503-636-3028",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kosta, Choate and Pierson, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.