Individual provider Active NPI

Tannus Erik Quatre, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1184600298
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4381 Issued in OR
Practice address
1465 SW Knoll Ave
Suite 207
Bend, OR 97702-3261
Phone
(541) 550-7291
Fax
(541) 550-7356
NPI assigned
Dec 20, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4381 OR Primary
Physical Therapist 225100000X 24730 CA
Physical Therapist 225100000X

Addresses

Primary practice location

1465 SW Knoll Ave
Suite 207
Bend, OR 97702-3261

Mailing address

PO Box 6173
Bend, OR 97708-6173
Phone (541) 550-7291

Other identifiers 1

IdentifierTypeStateIssuer
181650MedicaidOR

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

State licenses

LicenseStateTypeSpecialty
4381ORMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184600298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6173",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086173",
            "telephone_number": "541-550-7291",
            "fax_number": "541-550-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 SW KNOLL AVE",
            "address_2": "SUITE 207",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023261",
            "telephone_number": "541-550-7291",
            "fax_number": "541-550-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUATRE",
        "first_name": "TANNUS",
        "middle_name": "ERIK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4381",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "24730",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181650",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.