Individual provider Active NPI

Jeffery Richard Houck, PT

  • Orthopedic Physical Therapist
  • Newberg, OR
National Provider Identifier
1114779097
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
60397 Issued in OR
Practice address
414 N Meridian St
Newberg, OR 97132-2697
Phone
(585) 402-0381
NPI assigned
Apr 3, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 60397 OR Primary

Addresses

Primary practice location

414 N Meridian St
Newberg, OR 97132-2697

Mailing address

748 Mariner Cir
Webster, NY 14580-3908
Phone (585) 402-0381

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
60397ORMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
George Fox University PastSince Apr 9, 2024 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": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1114779097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 MARINER CIR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803908",
            "telephone_number": "585-402-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 N MERIDIAN ST",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971322697",
            "telephone_number": "585-402-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUCK",
        "first_name": "JEFFERY",
        "middle_name": "RICHARD",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "60397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.