Active NPI
Jennifer Lynne Rees-Gross, PT
- Physical Therapist
- Wilsonville, OR
National Provider Identifier
1053909127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1743
- Practice address
- 25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697 - Phone
- (402) 871-3843
- NPI assigned
- Jan 5, 2021
- 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 | 1743 | NE | Primary |
Addresses
Primary practice location
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Mailing address
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Phone (402) 871-3843
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1743 | NE | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609804800000",
"number": "1053909127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE STE D",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697",
"telephone_number": "402-871-3843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE STE D",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697",
"telephone_number": "402-871-3843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REES-GROSS",
"first_name": "JENNIFER",
"middle_name": "LYNNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-05",
"last_updated": "2021-01-05",
"certification_date": "2021-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "1743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilsonville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.