Individual provider Active NPI

Jandra Mueller, DPT

  • Physical Therapist
  • Newport, OR
National Provider Identifier
1063767630
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
06846 Issued in OR
Practice address
1010 SW Coast Hwy Ste 102
Newport, OR 97365-5239
Phone
(541) 265-4252
NPI assigned
Jul 19, 2012
Last updated
Jul 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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 06846 OR Primary

Addresses

Primary practice location

1010 SW Coast Hwy Ste 102
Newport, OR 97365-5239

Mailing address

1010 SW Coast Hwy Ste 102
Newport, OR 97365-5239
Phone (541) 265-4252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328002985 CA Practitioner - Physical Therapist in Private Practice 5294965711 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06846ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prendergast and Rummer Phys Therapy Pelvic Health & Rehabiliation Ctr Physical Therapist CurrentSince Nov 15, 2024 Accepting new patients
Shefit Physical Therapy Physical Therapist Past Accepting new patients
Akincilar and Prendergast, Inc Physical Therapist PastSince Sep 26, 2023 Accepting new patients

Locations

336 Encinitas Blvd
Ste 210
Encinitas, CA 92024
Phone (760) 487-5118

32 Daniel Webster Hwy
Ste 16
Merrimack, NH 03054
Phone (603) 589-9184

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1063767630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY STE 102",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655239",
            "telephone_number": "541-265-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY STE 102",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655239",
            "telephone_number": "541-265-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "JANDRA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "06846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.