Active NPI
Kelsie Jordan
- Physical Therapist
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 63428
- Practice address
- 10215 SW Park Way Ste D
Portland, OR 97225-5036 - Phone
- (503) 292-3583
- Fax
- (503) 292-1022
- NPI assigned
- Aug 20, 2019
- Last updated
- Aug 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 63428 | OR | Primary |
Addresses
Primary practice location
10215 SW Park Way Ste D
Portland, OR 97225-5036
Mailing address
16083 SW Upper Boones Ferry Rd Ste 300
Tigard, OR 97224-7736
Phone (503) 443-6156
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10215 SW Pkwy
Suite D
Portland, OR 97225-5036
Phone (503) 292-3583
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Associates Inc | Physical Therapist | Current | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Current | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Current | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
Locations
16315 SW Barrows Rd
Ste 205
Beaverton, OR 97007
Phone (503) 521-0500
10215 SW Parkway
Ste D
Portland, OR 97225
Phone (503) 292-3583
8028 NE Glisan St
Ste B
Portland, OR 97213
Phone (503) 253-0924
58147 Columbia River Hwy
Ste A
Saint Helens, OR 97051
Phone (503) 397-1914
20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691
16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153
29100 SW Town Center Loop W
Ste 190
Wilsonville, OR 97070
Phone (503) 570-7600
Interoperability endpoints
- kelsie.jordan.1@31414.direct.athenahealth.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba TAI Mt. Ashland Physical Therapy
- Physical Therapist
- Ashland, OR
- NPI 1972589364
-
dba TAI Cedar Hills Physical Therapy
- Physical Therapist
- Portland, OR
- NPI 1700862000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1043867575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "503-443-6156",
"fax_number": "503-639-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10215 SW PARK WAY STE D",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255036",
"telephone_number": "503-292-3583",
"fax_number": "503-292-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "KELSIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "63428",
"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 Aug 20, 2019; 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.