Individual provider Active NPI

Heather Anne Purdin, P.T.

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1043201197
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3705 Issued in OR
Practice address
4475 SW Scholls Ferry Rd
Suite 258
Portland, OR 97225-1955
Phone
(503) 292-5882
Fax
(503) 292-5899
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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 3705 OR Primary

Addresses

Primary practice location

4475 SW Scholls Ferry Rd
Suite 258
Portland, OR 97225-1955

Mailing address

4475 SW Scholls Ferry Rd
Suite 258
Portland, OR 97225-1955
Phone (503) 292-5882

Other names 1

  • Mrs. Heather Purdin Goodell Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040119000051 OR Practitioner - Physical Therapist in Private Practice 5395646731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
H and P Goodell IncGroup PAC ID 1153340476, 8 clinicians

Practice addresses (Care Compare)

4475 SW Scholls Ferry Rd
Suite 258
Portland, OR 97225-1958
Phone (503) 292-5882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3705ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
H & P Goodell, Inc. CurrentSince Aug 31, 2005 Accepting new patients

Locations

4475 SW Scholls Ferry Rd
Ste 258
Portland, OR 97225
Phone (503) 292-5882

4943 NE Mlk Jr Blvd
Portland, OR 97211
Phone (503) 610-3488

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1043201197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD",
            "address_2": "SUITE 258",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251955",
            "telephone_number": "503-292-5882",
            "fax_number": "503-292-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD",
            "address_2": "SUITE 258",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251955",
            "telephone_number": "503-292-5882",
            "fax_number": "503-292-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDIN",
        "first_name": "HEATHER",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "GOODELL",
            "middle_name": "PURDIN",
            "prefix": "MRS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.