Active NPI
Christine H Vergona, PT
- Physical Therapist
- Bend, OR
National Provider Identifier
1205982873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2671
- Practice address
- 1160 SW Simpson Ave
Suite 200
Bend, OR 97702-3542 - Phone
- (541) 322-9045
- Fax
- (541) 322-9044
- NPI assigned
- Jan 26, 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 | 2671 | OR | Primary |
Addresses
Primary practice location
1160 SW Simpson Ave
Suite 200
Bend, OR 97702-3542
Mailing address
805 SW Industrial Way
Suite 3
Bend, OR 97702-1093
Phone (541) 585-2529
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 158538 | Medicaid | OR |
Other names 1
- Christine H Masters
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 |
|---|---|---|---|
| 2671 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370304000000",
"number": "1205982873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 SW INDUSTRIAL WAY",
"address_2": "SUITE 3",
"city": "BEND",
"state": "OR",
"postal_code": "977021093",
"telephone_number": "541-585-2529",
"fax_number": "541-585-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 SW SIMPSON AVE",
"address_2": "SUITE 200",
"city": "BEND",
"state": "OR",
"postal_code": "977023542",
"telephone_number": "541-322-9045",
"fax_number": "541-322-9044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGONA",
"first_name": "CHRISTINE",
"middle_name": "H",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2013-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "2671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "158538",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTINE",
"last_name": "MASTERS",
"middle_name": "H",
"code": "1",
"type": "Former Name"
}
]
}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 Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.