Mary Fay Roberts, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62790 Issued in OR

Practice address

2635 NW Rolling Green Dr
Corvallis, OR 97330-3519

Phone

(541) 753-4246

NPI assigned

Jul 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Corvallis Sport and Spine Physical Therapy Inc

  • Physical Therapist
  • Albany, OR
  • NPI 1477991149
  NPD (past)

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1093201394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 NW ROLLING GREEN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303519",
            "telephone_number": "541-753-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 NW ROLLING GREEN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303519",
            "telephone_number": "541-753-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARY",
        "middle_name": "FAY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverstone Wellness LLC
• Casey Joanna Roach, MA
• Frank Clifford Roberson, M.D.
• Benjamin Edward Roberts
• Kellie Diane Roberts
• Sylvia Roberts
• Jessica Robertson, RDN
• Sean Thomas Robinson Schaffer
• Chandler Robinson
• Elena Kristine Robinson, COUNSELING INTERN

• Physical Therapist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.