Kelly Odell Dzon, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4831 Issued in OR

Practice address

1423 SE 23Rd Ave
Portland, OR 97214-3908

Phone

(503) 236-3108

Fax

(503) 236-3239

NPI assigned

Jun 1, 2006

Last updated

Aug 26, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Heights Integrative Therapy Inc

  dba New Heights Physical Therapy Plus

  • Physical Therapist
  • Portland, OR
  • NPI 1558308478
  NPD (past)
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)
• New Heights Integrative Therapy, Inc.

  dba New Heights Physical Therapy, Plus

  • Physical Therapist
  • Vancouver, WA
  • NPI 1922126937
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1336186923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 SE 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143908",
            "telephone_number": "503-236-3108",
            "fax_number": "503-236-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 SE 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143908",
            "telephone_number": "503-236-3108",
            "fax_number": "503-236-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZON",
        "first_name": "KELLY",
        "middle_name": "ODELL",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert D Dyson, MD
• Diandra Dzib
• Harper Elizabeth Dziedzic
• Joseph Dzierzawiec
• Amber Dzitko
• E3 Physio LLC
• Each Peach Family Wellness
• Brenda Eads
• Michael Andre Eads
• Jessica Dawn Eagan, MSW, MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.