NPIMap

Organization Active NPI

Active Edge Physical Therapy, LLC

  • Orthopedic Physical Therapist
  • Oregon City, OR
National Provider Identifier
1043685068
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
04568 Issued in OR
Legal business name
ACTIVE EDGE PHYSICAL THERAPY, LLC
Practice address
19727 South Highway 213
Oregon City, OR 97045
Phone
(503) 387-5449
Fax
(503) 342-6846
NPI assigned
Dec 2, 2015
Last updated
Dec 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Mr. Daniel C Morlan, PT
Title
Managing Partner
Phone
(503) 387-5449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 04568 OR Primary

Addresses

Primary practice location

19727 South Highway 213
Oregon City, OR 97045

Mailing address

2090 Tanner Creek LN
West Linn, OR 97068-3671
Phone (503) 387-5449

National Provider Directory

National Provider Directory
Tax ID family
Active Edge Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19721 S Highway 213
Oregon City, OR 97045
Phone (503) 305-8455

Practitioners & affiliated clinicians

Practitioners 10

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": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1043685068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 TANNER CREEK LN",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683671",
            "telephone_number": "503-387-5449",
            "fax_number": "503-342-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19727 SOUTH HIGHWAY 213",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "97045",
            "telephone_number": "503-387-5449",
            "fax_number": "503-342-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE EDGE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "MORLAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "503-387-5449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "04568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.