Active NPI
David Allan Byerly, MOT, OTR/L
- Occupational Therapist
- Portland, OR
National Provider Identifier
1063978666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 415390
- Practice address
- 4805 NE Glisan St
Portland, OR 97213-2933 - Phone
- (971) 219-5578
- NPI assigned
- Feb 19, 2019
- Last updated
- Jun 30, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | |||
| Occupational Therapist | 225X00000X | 415390 | OR | Primary |
Addresses
Primary practice location
4805 NE Glisan St
Portland, OR 97213-2933
Mailing address
4805 NE Glisan St
Portland, OR 97213-2933
Phone (971) 219-5578
Other practice location 1
5905 SE Powell Valley Rd
Gresham, OR 97080-1919
Phone (503) 665-1151
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1063978666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4805 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132933",
"telephone_number": "971-219-5578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4805 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132933",
"telephone_number": "971-219-5578"
}
],
"practiceLocations": [
{
"address_1": "5905 SE Powell Valley Rd",
"address_purpose": "LOCATION",
"city": "Gresham",
"state": "OR",
"postal_code": "970801919",
"country_code": "US",
"telephone_number": "503-665-1151",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BYERLY",
"first_name": "DAVID",
"middle_name": "ALLAN",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-19",
"last_updated": "2023-06-30",
"certification_date": "2023-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "415390",
"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 Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.