Individual provider Active NPI

Alan M Noble, PT, DPT

  • Physical Therapist
  • Dallas, OR
National Provider Identifier
1205248960
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60621 Issued in OR
Practice address
210 W Ellendale Ave Ste 100
Dallas, OR 97338-1790
Phone
(503) 623-2433
Fax
(503) 623-2196
NPI assigned
May 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 60621 OR Primary

Addresses

Primary practice location

210 W Ellendale Ave Ste 100
Dallas, OR 97338-1790

Mailing address

210 W Ellendale Ave Ste 100
Dallas, OR 97338-1790
Phone (503) 623-2433

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

LicenseStateTypeSpecialty
60621ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Rehabilitation Associates, Inc. Physical Therapist CurrentSince Nov 8, 2024 Accepting new patients

Locations

210 W Ellendale Ave
Ste 100
Dallas, OR 97338
Phone (503) 623-2433

3220 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779

3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1205248960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W ELLENDALE AVE STE 100",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381790",
            "telephone_number": "503-623-2433",
            "fax_number": "503-623-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W ELLENDALE AVE STE 100",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381790",
            "telephone_number": "503-623-2433",
            "fax_number": "503-623-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "ALAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.