Active NPI
Walter Libby
- Mechanotherapist
- Eugene, OR
National Provider Identifier
1144400862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 5122
- Practice address
- 1695 Jefferson St
Eugene, OR 97402-4063 - Phone
- (541) 344-9700
- NPI assigned
- Nov 9, 2007
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 5122 | OR | Primary |
Addresses
Primary practice location
1695 Jefferson St
Eugene, OR 97402-4063
Mailing address
1695 Jefferson St
Eugene, OR 97402-4063
Phone (541) 344-9700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5122 | Other | MASSAGE THERAPIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1144400862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1695 JEFFERSON ST",
"city": "EUGENE",
"state": "OR",
"postal_code": "974024063",
"telephone_number": "541-344-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1695 JEFFERSON ST",
"city": "EUGENE",
"state": "OR",
"postal_code": "974024063",
"telephone_number": "541-344-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBBY",
"first_name": "WALTER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-09",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "OR",
"license": "5122",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE THERAPIST",
"identifier": "5122",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.