St. Johns Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ST. JOHNS PHYSICAL THERAPY

Practice address

8835 N Bradford St
Portland, OR 97203-2869

Phone

(360) 770-4215

NPI assigned

Nov 18, 2019

Organization subpart

No

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

Authorized official

Name

Paul Cooley, DPTNPI 1831572023

Title

Owner and Lead Clinician

Phone

(360) 770-4215

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

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

• Paul Cooley, DPT

  • Physical Therapist
  • Portland, OR
  • NPI 1831572023
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1144865841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8835 N BRADFORD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972032869",
            "telephone_number": "360-770-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8835 N BRADFORD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972032869",
            "telephone_number": "360-770-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHNS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "COOLEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER AND LEAD CLINICIAN",
        "authorized_official_telephone_number": "360-770-4215",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leland St. Charles, PSY.D.
• Amanda St. Clair
• Valerie Ann St. Clair
• Luke St. John
• Samuel St. John
• St. Jude Operating Company, LLC
• Shannon Alexis St. Laurent, AUD
• Carissa Marie St. Onge Carneiro, CNM
• Brittany Nicole St. Onge
• St. Vincent'S Hospitol

• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.