Nicholas Robert Mong, P.T., D.P.T., A.T.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05888 Issued in OR

Practice address

735 SW 158TH Ave # 160
Beaverton, OR 97006-4952

Phone

(503) 597-0035

Fax

(503) 296-2985

NPI assigned

Oct 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dimond Physical Therapy and Performance Lab, LLC

  • Physical Therapist
  • Beaverton, OR
  • NPI 1184864365
  NPD (past)
• Erhardt Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Scappoose, OR
  • NPI 1326110313
  NPD (past)

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266624000000",
    "number": "1265767834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 SW 158TH AVE # 160",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064952",
            "telephone_number": "503-597-0035",
            "fax_number": "503-296-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 SW 158TH AVE # 160",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064952",
            "telephone_number": "503-597-0035",
            "fax_number": "503-296-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONG",
        "first_name": "NICHOLAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "P.T., D.P.T., A.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2010-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "05888",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT004181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Nmi Moller, PA
• Molly Hamilton LMT
• Monarch Medical Group LLC
• Julieta Mondragon
• Golnoush Monfared
• Laura Allouette Monroe Wright, CSWA
• Viktoriya D Monroe, MD
• Lena T Monteverdi, QMHP
• Sheila Annette Montgomery, LMT
• Susan Montiel- Hernandez

• Physical Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2010; 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.