Elite Performance Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ELITE PERFORMANCE PHYSICAL THERAPY, LLC

Practice address

22695 S Upper Highland Rd
Beavercreek, OR 97004-9732

Phone

(503) 708-6941

NPI assigned

Jul 13, 2015

Organization subpart

No

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

Authorized official

Name

Jessie Roberts, DPT

Title

Owner

Phone

(503) 708-6941

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1225412927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19146 S MOLALLA AVE STE A",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970457167",
            "telephone_number": "503-974-0048",
            "fax_number": "503-974-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22695 S UPPER HIGHLAND RD",
            "city": "BEAVERCREEK",
            "state": "OR",
            "postal_code": "970049732",
            "telephone_number": "503-708-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PERFORMANCE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-708-6941",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "04620",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy L Aasland, LMT
• At Your Door Dental
• Laura Bartko, CNM
• Discovery Practice Management, Inc.
• Deborah Frances, N.D.
• Greg Glenn Gill Jr.
• Vicki Lynn Miracle, R.N.
• Joelle Osterhaus, LCSW
• Jessie Lynn Roberts, DPT

• Physical Therapy Clinic/Center in Beavercreek, OR
• Providers in Beavercreek, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.