Active NPI
Tiffany Carlson
- Kinesiotherapist
- West Linn, OR
National Provider Identifier
1265783518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Kinesiotherapist
- License
- T59079
- Practice address
- 1750 Blankenship Rd
Suite 295
West Linn, OR 97068-5101 - Phone
- (503) 344-4378
- NPI assigned
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Kinesiotherapist | 226300000X | T59079 | OR | Primary |
Addresses
Primary practice location
1750 Blankenship Rd
Suite 295
West Linn, OR 97068-5101
Mailing address
PO Box 1862
Oregon City, OR 97045-0042
Phone (503) 313-3373
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T59079 | OR | MD | Kinesiotherapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Injury and Wellness, PC | 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 and National Provider Directory roles.
-
- Chiropractor
- West Linn, OR
- NPI 1952698680
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1265783518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1862",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970450042",
"telephone_number": "503-313-3373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 BLANKENSHIP RD",
"address_2": "SUITE 295",
"city": "WEST LINN",
"state": "OR",
"postal_code": "970685101",
"telephone_number": "503-344-4378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "TIFFANY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-26",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": "OR",
"license": "T59079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Linn, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.