Active NPI
Nancy Penrod Monnie, DPT
- Physical Therapist
- Sandy, OR
National Provider Identifier
1154537033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1094
- Practice address
- 16621 Champion Way
Suite 100
Sandy, OR 97055-7257 - Phone
- (503) 668-5321
- Fax
- (503) 668-9742
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 1094 | OR | Primary |
Addresses
Primary practice location
16621 Champion Way
Suite 100
Sandy, OR 97055-7257
Mailing address
1711 SE 26TH CT
Gresham, OR 97080-5291
Phone (503) 667-5880
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0308 | Other | OR | QUAL-MED |
| 071787 | Medicaid | OR | |
| C884 X 0 | Other | OR | PACC |
| 86971 | Other | OR | KAISER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1094 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1154537033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 SE 26TH CT",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970805291",
"telephone_number": "503-667-5880",
"fax_number": "503-669-6555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16621 CHAMPION WAY",
"address_2": "SUITE 100",
"city": "SANDY",
"state": "OR",
"postal_code": "970557257",
"telephone_number": "503-668-5321",
"fax_number": "503-668-9742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONNIE",
"first_name": "NANCY",
"middle_name": "PENROD",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "1094",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUAL-MED",
"identifier": "0308",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071787",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACC",
"identifier": "C884 X 0",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "86971",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandy, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.