Individual provider Active NPI

Jeffrey John Tjaarda, M.P.T.

  • Physical Therapist
  • Springfield, OR
National Provider Identifier
1104962091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5035 Issued in OR
Practice address
145 S 52ND PL
Springfield, OR 97478-6210
Phone
(541) 988-3337
Fax
(541) 988-3299
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5035 OR Primary

Addresses

Primary practice location

145 S 52ND PL
Springfield, OR 97478-6210

Mailing address

145 S 52ND PL
Springfield, OR 97478-6210
Phone (541) 988-3337

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Crossing Orthopedic Physical Therapy Inc Physical Therapist PastSince Jan 1, 2001 Accepting new patients

Organizations & group practices 1

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104962091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S 52ND PL",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786210",
            "telephone_number": "541-988-3337",
            "fax_number": "541-988-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S 52ND PL",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786210",
            "telephone_number": "541-988-3337",
            "fax_number": "541-988-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJAARDA",
        "first_name": "JEFFREY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.