Active NPI
Tracy Lyn Fritts, PHYSICAL THERAPIST
- Physical Therapist
- Milwaukie, OR
National Provider Identifier
1235287699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2590
- Practice address
- 4560 SE International Way
Consonus Rehab Services Suite 100
Milwaukie, OR 97222 - Phone
- (971) 206-5140
- Fax
- (971) 206-5209
- NPI assigned
- Jan 8, 2007
- Last updated
- Jul 8, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2590 | OR | Primary |
| Physical Therapist | 225100000X | PT 00008778 | WA |
Addresses
Primary practice location
4560 SE International Way
Consonus Rehab Services Suite 100
Milwaukie, OR 97222
Mailing address
4560 SE International Way
Suite 100
Milwaukie, OR 97222
Phone (971) 206-5140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116595 | Medicaid | OR |
Other names 1
- Miss Tracy Lyn Barnes
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 |
|---|---|---|---|
| PT 00008778 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Specialists I, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235287699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "SUITE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5140",
"fax_number": "971-206-5209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "CONSONUS REHAB SERVICES SUITE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5140",
"fax_number": "971-206-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRITTS",
"first_name": "TRACY",
"middle_name": "LYN",
"name_prefix": "Ms.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "2590",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT 00008778",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116595",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TRACY",
"last_name": "BARNES",
"middle_name": "LYN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.