Active NPI
Roger Scott Wegley, PHYSICAL THERAPIST
- Physical Therapist
- Seattle, WA
National Provider Identifier
1306829254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00003235
- Practice address
- 5420 Barnes Ave NW
Seattle, WA 98107-3839 - Phone
- (206) 789-7975
- Fax
- (206) 782-6177
- NPI assigned
- Nov 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00003235 | WA | Primary |
| Physical Therapist | 225100000X | PT-26 72 | ID | |
| Physical Therapist | 225100000X | 1018 | OR |
Addresses
Primary practice location
5420 Barnes Ave NW
Seattle, WA 98107-3839
Mailing address
16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306829254 | Medicaid | WA | |
| P01689894 | Other | ID | RR MEDICARE |
| 1306829254 - 000 | Medicaid | ID | |
| 650007475 | Other | WA | RR MEDICARE |
| 0321841 | Other | WA | WASHINGTON L & I |
| 500630816 | Medicaid | OR | |
| 8334864 | Medicaid | WA | |
| 0054187 | Other | WA | WASHINGTON L&I |
| 1039348 | Medicaid | WA | |
| 0274833 | Other | WA | WA L & I |
| 0330318 | Other | ID | WA L&I |
| P01564222 | Other | WA | RR MEDICARE |
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 |
|---|---|---|---|
| 1018 | OR | MD | Clinical Psychologist |
| PT-26 72 | ID | MD | Physical Therapist |
| PT00003235 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | 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 |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba TAI Boise Physical Therapy State Street
- Physical Therapist
- Boise, ID
- NPI 1326024472
-
dba TAI West Eugene Physical Therapy
- Physical Therapist
- Eugene, OR
- NPI 1497731855
-
dba TAI Cedar Hills Physical Therapy
- Physical Therapist
- Portland, OR
- NPI 1700862000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1306829254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD",
"address_2": "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": "5420 BARNES AVE NW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981073839",
"telephone_number": "206-789-7975",
"fax_number": "206-782-6177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGLEY",
"first_name": "ROGER",
"middle_name": "SCOTT",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00003235",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-26 72",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "1018",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306829254",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01689894",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306829254 - 000",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "650007475",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON L & I",
"identifier": "0321841",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500630816",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8334864",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON L&I",
"identifier": "0054187",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1039348",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA L & I",
"identifier": "0274833",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA L&I",
"identifier": "0330318",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01564222",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.