Individual provider Active NPI

Daniel Eldrenkamp

  • Occupational Therapist
  • Portland, OR
National Provider Identifier
1043511512
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
277926 Issued in OR
Practice address
1620 SE Cesar E Chavez Blvd Apt 217
Portland, OR 97214-5260
Phone
(641) 799-3927
NPI assigned
Nov 15, 2010
Last updated
Nov 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 277926 OR Primary

Addresses

Primary practice location

1620 SE Cesar E Chavez Blvd Apt 217
Portland, OR 97214-5260

Mailing address

1620 SE Cesar E Chavez Blvd Apt 217
Portland, OR 97214-5260
Phone (641) 799-3927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
277926ORMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1043511512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 SE CESAR E CHAVEZ BLVD APT 217",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145260",
            "telephone_number": "641-799-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 SE CESAR E CHAVEZ BLVD APT 217",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145260",
            "telephone_number": "641-799-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRENKAMP",
        "first_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "277926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 15, 2010; 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.