Active NPI
Colleen C McGinnis, PT, DPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1265694780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 06295
- Practice address
- 2001 NW 19TH Ave
Portland, OR 97209 - Phone
- (503) 723-5049
- Fax
- (503) 655-9305
- NPI assigned
- Jun 26, 2008
- 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 | 06295 | OR | Primary |
Addresses
Primary practice location
2001 NW 19TH Ave
Portland, OR 97209
Mailing address
1554 Garden St
West Linn, OR 97068-3278
Phone (503) 723-5049
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 |
|---|---|---|---|
| 06295 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560988800000",
"number": "1265694780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1554 GARDEN ST",
"city": "WEST LINN",
"state": "OR",
"postal_code": "970683278",
"telephone_number": "503-723-5049",
"fax_number": "503-655-9305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 NW 19TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97209",
"telephone_number": "503-723-5049",
"fax_number": "503-655-9305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGINNIS",
"first_name": "COLLEEN",
"middle_name": "C",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-26",
"last_updated": "2019-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "06295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.