Active NPI
Jessica McGuire, PT, DPT
- Physical Therapist
- Salem, OR
National Provider Identifier
1215273412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60821
- Practice address
- 1600 State St
Salem, OR 97301-4257 - Phone
- (503) 540-6300
- NPI assigned
- Dec 17, 2012
- 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 | PT60821 | OR | Primary |
Addresses
Primary practice location
1600 State St
Salem, OR 97301-4257
Mailing address
1600 State St
Salem, OR 97301-4257
Phone (503) 540-6300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500679921 | Medicaid | OR | |
| PT60821 | Other | OR | LICENSE |
Other names 1
- Jessica Carlson
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 |
|---|---|---|---|
| PT60821 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427155200000",
"number": "1215273412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 STATE ST",
"city": "SALEM",
"state": "OR",
"postal_code": "973014257",
"telephone_number": "503-540-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 STATE ST",
"city": "SALEM",
"state": "OR",
"postal_code": "973014257",
"telephone_number": "503-540-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGUIRE",
"first_name": "JESSICA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-17",
"last_updated": "2015-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "PT60821",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500679921",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PT60821",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "CARLSON",
"credential": "PT, DPT",
"code": "1",
"type": "Former Name"
}
]
}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 Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.