Individual provider Active NPI

Jered Alrick, LMT

  • Specialist
  • Portland, OR
National Provider Identifier
1083158539
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
22449 Issued in OR
Practice address
3150 SE Belmont St
Portland, OR 97214-4029
Phone
(503) 389-5545
NPI assigned
Dec 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 22449 OR
Specialist 174400000X 22449 OR Primary

Addresses

Primary practice location

3150 SE Belmont St
Portland, OR 97214-4029

Mailing address

1170 S Water St
Silverton, OR 97381-2442
Phone (541) 740-1817

Other practice location 1

29781 SW Town Center Loop W Ste 100
Wilsonville, OR 97070-8901
Phone (503) 682-3811

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
22449ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wellness Center LLC CurrentSince Mar 27, 2022 Accepting new patients
Advanced Wellness Center CurrentSince Mar 27, 2022 Accepting new patients
David a Duemling, DC PC PastSince Feb 26, 2018 Accepting new patients

Locations

3150 SE Belmont St
Portland, OR 97214
Phone (503) 376-6881

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1083158539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 S WATER ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973812442",
            "telephone_number": "541-740-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144029",
            "telephone_number": "503-389-5545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29781 SW Town Center Loop W Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wilsonville",
            "state": "OR",
            "postal_code": "970708901",
            "country_code": "US",
            "telephone_number": "503-682-3811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALRICK",
        "first_name": "JERED",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-16",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "22449",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "22449",
            "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 Mar 21, 2022; 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.