Active NPI
Richard Eugene Lague, PT
- Orthopedic Physical Therapist
- Corvallis, OR
National Provider Identifier
1114097649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 0772
- Practice address
- HFC Dixon Recreation Center
Oregon State University
Corvallis, OR 97331 - Phone
- (541) 737-7556
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 0772 | OR | Primary |
| Orthopedic Physical Therapist | 2251X0800X | PT00002123 | WA |
Addresses
Primary practice location
HFC Dixon Recreation Center
Oregon State University
Corvallis, OR 97331
Mailing address
630 SW 2ND St
Corvallis, OR 97333-4442
Phone (541) 757-2726
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0772 | OR | MD | Orthopedic Physical Therapist |
| PT00002123 | WA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114097649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 SW 2ND ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973334442",
"telephone_number": "541-757-2726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HFC DIXON RECREATION CENTER",
"address_2": "OREGON STATE UNIVERSITY",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "97331",
"telephone_number": "541-737-7556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGUE",
"first_name": "RICHARD",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "OR",
"license": "0772",
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "WA",
"license": "PT00002123",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corvallis, 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.