NPIMap

Organization Active NPI

Active Edge Physical Therapy, LLC

  • Orthopedic Physical Therapist
  • Oregon City, OR
National Provider Identifier
1134584774
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
04568 Issued in OR
Legal business name
ACTIVE EDGE PHYSICAL THERAPY, LLC
Practice address
19721 S Highway 213
Oregon City, OR 97045-4190
Phone
(503) 387-5449
NPI assigned
Dec 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Authorized official

Name
Mr. Daniel C. Morlan, PT
Title
President
Phone
(503) 387-5449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 04568 OR Primary

Addresses

Primary practice location

19721 S Highway 213
Oregon City, OR 97045-4190

Mailing address

2090 Tanner Creek LN
West Linn, OR 97068-3671
Phone (503) 387-5449

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Active Edge Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1134584774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 TANNER CREEK LN",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683671",
            "telephone_number": "503-387-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19721 S HIGHWAY 213",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454190",
            "telephone_number": "503-387-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE EDGE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "MORLAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-387-5449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "04568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.