NPIMap

Organization Active NPI

Stratos Group LLC

Doing business as Evolve Physical Therapy

  • Physical Therapy Clinic/Center
  • Sherwood, OR
National Provider Identifier
1003357930
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
STRATOS GROUP LLC
Doing business as
Evolve Physical Therapy
Practice address
20510 SW Roy Rogers Rd
Suite 120
Sherwood, OR 97140-9319
Phone
(707) 841-7718
NPI assigned
Mar 10, 2017
Last updated
Mar 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Authorized official

Name
Matthew Lyle Whitaker, PTNPI 1932427937
Title
Owner
Phone
(707) 841-7718

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

20510 SW Roy Rogers Rd
Suite 120
Sherwood, OR 97140-9319

Mailing address

20510 SW Roy Rogers Rd
Suite 120
Sherwood, OR 97140-9319
Phone (707) 841-7718

Other names 1

  • Evolve Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170714001977 OR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709155534 Receives reassigned benefits from 11 practitioners
Practice locations: Portland, OR; Sherwood, OR

National Provider Directory

National Provider Directory

Locations

18215 NW West Union Rd
Ste B
Portland, OR 97229
Phone (971) 213-3335

20510 SW Roy Rogers Rd
Ste 120
Sherwood, OR 97140
Phone (971) 213-3335

Practitioners & affiliated clinicians

Practitioners 12

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": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1003357930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20510 SW ROY ROGERS RD",
            "address_2": "SUITE 120",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409319",
            "telephone_number": "707-841-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20510 SW ROY ROGERS RD",
            "address_2": "SUITE 120",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409319",
            "telephone_number": "707-841-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRATOS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-841-7718",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherwood, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.