Individual provider Active NPI

Jennifer Ann Hargis, DPT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1215086079
Registry record updated Feb 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4970 Issued in OR
Practice address
7203 SE Raymond St
Portland, OR 97206-4323
Phone
(503) 895-1320
Fax
(503) 296-2319
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2014

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 4970 OR Primary

Addresses

Primary practice location

7203 SE Raymond St
Portland, OR 97206-4323

Mailing address

12948 SE Winston Rd
Damascus, OR 97089-7606
Phone (503) 895-1320

Other identifiers 2

IdentifierTypeStateIssuer
269781MedicaidOR
8429656MedicaidWA

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
4970ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Intensive Therapy Past Accepting new patients
Childrens Intensive Therapy Northwest Past Accepting new patients

Organizations & group practices 2

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391817600000",
    "number": "1215086079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12948 SE WINSTON RD",
            "city": "DAMASCUS",
            "state": "OR",
            "postal_code": "970897606",
            "telephone_number": "503-895-1320",
            "fax_number": "503-296-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7203 SE RAYMOND ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064323",
            "telephone_number": "503-895-1320",
            "fax_number": "503-296-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGIS",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269781",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8429656",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2014; 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.