Individual provider Active NPI

Johnathan Miller

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1285203927
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
16083 SW Upper Boones Ferry Rd Ste 300
Portland, OR 97224-7736
Phone
(503) 443-6156
NPI assigned
Jun 17, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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 Primary

Addresses

Primary practice location

16083 SW Upper Boones Ferry Rd Ste 300
Portland, OR 97224-7736

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Portland, OR 97224-7736
Phone (503) 443-6156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210630002795 OR Practitioner - Physical Therapist in Private Practice 0941601728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Motion Physical Therapy, Inc.Group PAC ID 8426078361, 36 clinicians

Practice addresses (Care Compare)

340 Vista Ave SE
Suite 250
Salem, OR 97302-4546
Phone (971) 301-6225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Motion Physical Therapy, Inc. Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Pediatric Therapy Services Inc Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

732 Main St
Philomath, OR 97370
Phone (541) 929-2255

340 Vista Ave SE
Ste 250
Salem, OR 97302
Phone (971) 301-6225

Organizations & group practices 4

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": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1285203927",
    "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": "PORTLAND",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOHNATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 17, 2021; 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.