Active NPI
Raechel Jennifer Massie, M.P.T.
- Physical Therapist
- Wheeler, OR
National Provider Identifier
1194929414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2437
- Practice address
- 278 Rowe Street
Wheeler, OR 97147 - Phone
- (503) 368-4978
- Fax
- (503) 368-4979
- NPI assigned
- Jun 12, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2437 | OR | Primary |
Addresses
Primary practice location
278 Rowe Street
Wheeler, OR 97147
Mailing address
PO Box 278
Nehalem, OR 97131-0278
Phone (503) 368-4978
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 920195896 | Other | OR | REGENCE BLUE CROSS BLUE S |
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 |
|---|---|---|---|
| 2437 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194929414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 278",
"city": "NEHALEM",
"state": "OR",
"postal_code": "971310278",
"telephone_number": "503-368-4978",
"fax_number": "503-368-4979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 ROWE STREET",
"city": "WHEELER",
"state": "OR",
"postal_code": "97147",
"telephone_number": "503-368-4978",
"fax_number": "503-368-4979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSIE",
"first_name": "RAECHEL",
"middle_name": "JENNIFER",
"name_prefix": "Ms.",
"credential": "M.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "2437",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE CROSS BLUE S",
"identifier": "920195896",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheeler, 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.