Active NPI
Jeffery Richard Houck, PT
- Orthopedic Physical Therapist
- Newberg, OR
National Provider Identifier
1114779097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 60397
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 60397 | OR | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| George Fox University | Past | 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.
-
- Athletic Trainer
- Newberg, OR
- NPI 1770613036
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.