Active NPI
Justin Robert Scheckler, PTA, BS
- Physical Therapy Assistant
- Tualatin, OR
National Provider Identifier
1124590526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 09399
- Practice address
- 19945 SW Boones Ferry Rd
Tualatin, OR 97062-7272 - Phone
- (503) 612-5500
- NPI assigned
- Dec 23, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 09399 | OR | Primary |
Addresses
Primary practice location
19945 SW Boones Ferry Rd
Tualatin, OR 97062-7272
Mailing address
19945 SW Boones Ferry Rd
Tualatin, OR 97062-7272
Phone (203) 309-7328
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09399 | OR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545523200000",
"number": "1124590526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19945 SW BOONES FERRY RD",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627272",
"telephone_number": "203-309-7328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19945 SW BOONES FERRY RD",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627272",
"telephone_number": "503-612-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHECKLER",
"first_name": "JUSTIN",
"middle_name": "ROBERT",
"credential": "PTA, BS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-23",
"last_updated": "2018-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "OR",
"license": "09399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.