Portland Sports Medicine & Spine Physical Therapy Inc.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

4503 Issued in OR

Legal business name

PORTLAND SPORTS MEDICINE & SPINE PHYSICAL THERAPY INC.

Practice address

1610 SE Glenwood St
Portland, OR 97202-5615

Phone

(503) 230-1744

Fax

(503) 230-1745

NPI assigned

Jul 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Paul Quesnell, P.T.NPI 1497775480

Title

Physical Therapist

Phone

(503) 230-1744

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Paul Quesnell, P.T.

  • Physical Therapist
  • Portland, OR
  • NPI 1497775480
  Medicare reassignment Care Compare group NPD Authorized official
• Aimee Catherine Guarriello, PT, OCS, CSCS

  • Physical Therapist
  • Portland, OR
  • NPI 1689703944
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1215127873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 SE GLENWOOD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025615",
            "telephone_number": "503-230-1744",
            "fax_number": "503-230-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 SE GLENWOOD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025615",
            "telephone_number": "503-230-1744",
            "fax_number": "503-230-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND SPORTS MEDICINE & SPINE PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "QUESNELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "503-230-1744",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "4503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portland Sex Therapy, LLC
• Portland SNF Operations, LLC (Portland Health & Rehabilitation Center)
• Portland Specific Chiropractic, LLC (Portland Specific Chiropractic)
• Portland Spine & Neck Surgery, P.C.
• Portland Spine Center LLC
• Portland State University Center for Student Health and Counseling
• Portland Surgeons, PC
• Portland Surgical Oncology, PC
• Portland Surgical Specialists, PC
• Portland Therapy Project LLC

• Orthopedic Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Orthopedic Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.