Active NPI
Judith Ann Messoline, LPTA
- Physical Therapy Assistant
- Salem, OR
National Provider Identifier
1205940749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 7916
- Practice address
- 5125 Skyline Rd S
Salem, OR 97306-9427 - Phone
- (503) 361-5400
- Fax
- (503) 588-6577
- NPI assigned
- Aug 19, 2006
- 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 Therapy Assistant | 225200000X | 7916 | OR | Primary |
Addresses
Primary practice location
5125 Skyline Rd S
Salem, OR 97306-9427
Mailing address
1857 Rye LN NW
Salem, OR 97304-1308
Phone (502) 585-0609
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7916 | OR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205940749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1857 RYE LN NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973041308",
"telephone_number": "502-585-0609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5125 SKYLINE RD S",
"city": "SALEM",
"state": "OR",
"postal_code": "973069427",
"telephone_number": "503-361-5400",
"fax_number": "503-588-6577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESSOLINE",
"first_name": "JUDITH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OR",
"license": "7916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, 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.