Individual provider Active NPI

Jason Weld

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1073981379
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
T 61375 Issued in OR
Practice address
5601 SE 122ND Ave
Portland, OR 97236-4601
Phone
(503) 761-3181
NPI assigned
Sep 3, 2015
Last updated
Sep 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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 T 61375 OR Primary

Addresses

Primary practice location

5601 SE 122ND Ave
Portland, OR 97236-4601

Mailing address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697

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

LicenseStateTypeSpecialty
T 61375ORMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1073981379",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 SE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972364601",
            "telephone_number": "503-761-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELD",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "T 61375",
            "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 Sep 3, 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.