Bright Spot Pediatric Therapy LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

1042968 Issued in OR

Legal business name

BRIGHT SPOT PEDIATRIC THERAPY LLC

Practice address

1425 N Killingsworth St
Portland, OR 97217-4541

Phone

(503) 575-9402

Fax

(888) 769-4431

NPI assigned

Jun 15, 2017

Last updated

Jan 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Moskal

Title

Owner

Phone

(503) 850-8154

Specialties & licenses 3

Addresses

Other identifiers 1

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.

• Amy Buchholz, OTR/L

  • Occupational Therapist
  • Portland, OR
  • NPI 1922475730
  NPD

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1033649694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174541",
            "telephone_number": "503-850-8154",
            "fax_number": "844-234-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174541",
            "telephone_number": "503-575-9402",
            "fax_number": "888-769-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SPOT PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "MOSKAL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-850-8154"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "1042968",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500796699",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brighter Days LLC
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• Brightline Counseling Inc
• Brightside Care

• Pediatric Occupational Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.