Individual provider Active NPI

Jennifer Kearsley

  • Physical Therapist
  • Scappoose, OR
National Provider Identifier
1235538711
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60759 Issued in OR
Practice address
51577 Columbia River Hwy Ste a
Scappoose, OR 97056-8409
Phone
(503) 543-0254
Fax
(503) 543-0259
NPI assigned
Aug 20, 2014
Last updated
May 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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 60759 OR Primary

Addresses

Primary practice location

51577 Columbia River Hwy Ste a
Scappoose, OR 97056-8409

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other names 1

  • Jennifer Campo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141029002807 OR Practitioner - Physical Therapist in Private Practice 8729209077 Reassigns benefits to 1 organization
I20200115003050 WA Practitioner - Physical Therapist in Private Practice 8729209077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

16315 SW Barrows Rd
Suite 205
Beaverton, OR 97007-9461
Phone (503) 521-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60759ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist CurrentSince Aug 19, 2014 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Aug 19, 2014 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Nov 2, 2019 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16315 SW Barrows Rd
Ste 205
Beaverton, OR 97007
Phone (503) 521-0500

996 NW Circle Blvd
Ste 101
Corvallis, OR 97330
Phone (541) 757-0878

2911 Tennyson Ave
Ste 204
Eugene, OR 97408
Phone (541) 515-6194

2005 Elm St
Ste 200
Forest Grove, OR 97116
Phone (503) 357-9810

702 SW Ramsey Ave
Ste 220
Grants Pass, OR 97527
Phone (541) 479-0765

5955 Shoreview Ln N
Ste 100
Keizer, OR 97303
Phone (503) 463-4221

15796 SE McLoughlin Blvd
Oak Grove, OR 97267
Phone (503) 653-5763

10215 SW Parkway
Ste D
Portland, OR 97225
Phone (503) 292-3583

1307 NE 102nd Ave
Ste G
Portland, OR 97220
Phone (503) 253-0924

8028 NE Glisan St
Ste B
Portland, OR 97213
Phone (503) 253-0924

2040 NW Newcastle St
Roseburg, OR 97471
Phone (541) 673-1808

58147 Columbia River Hwy
Ste A
Saint Helens, OR 97051
Phone (503) 397-1914

51577 Columbia River Hwy
Ste A
Scappoose, OR 97056
Phone (503) 543-0254

20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

29100 SW Town Center Loop W
Ste 190
Wilsonville, OR 97070
Phone (503) 570-7600

4250 Martin Way E
Ste 105
Olympia, WA 98516
Phone (360) 486-0640

17700 SE Mill Plain Blvd
Ste 150
Vancouver, WA 98683
Phone (360) 514-9383

Interoperability endpoints

  • Direct secure messaging: jennifer.kearsley.1@31414.direct.athenahealth.com

Organizations & group practices 8

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": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1235538711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51577 COLUMBIA RIVER HWY STE A",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970568409",
            "telephone_number": "503-543-0254",
            "fax_number": "503-543-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARSLEY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CAMPO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scappoose, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.