Jesse Stuckey

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6416 Issued in OR

Practice address

101 S State St Ste 200G
Lake Oswego, OR 97034-3900

Phone

(503) 636-3028

Fax

(503) 636-1837

NPI assigned

Apr 19, 2007

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

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Colorado, LLCGroup PAC ID 0446641179, 99 clinicians

Practice addresses (Care Compare)

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.

• Empowerme Rehabilitation Colorado, LLC

  • Multi-Specialty Clinic/Center
  • Denver, CO
  • NPI 1063176493

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• North Lake Physical Therapy and Rehabilitation, Inc.

  • Physical Therapist
  • Portland, OR
  • NPI 1376810671
  NPD (past)
• Advanced Performance & Rehabilitation Services Inc

  • Physical Therapy Clinic/Center
  • Bozeman, MT
  • NPI 1326064916

  Physical Therapist

  NPD (past)
• Rehability, PC

  • Physical Therapy Clinic/Center
  • Belgrade, MT
  • NPI 1316967250
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1336366558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S STATE ST STE 200G",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343900",
            "telephone_number": "503-636-3028",
            "fax_number": "503-636-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S STATE ST STE 200G",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343900",
            "telephone_number": "503-636-3028",
            "fax_number": "503-636-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "JESSE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204961",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Strealy, RDN, LD
• Cade Strickland
• Alex Melton Strozier III, MOT, OTR/L
• Gregory Strum, M.D.
• Stuart Malkin Counseling
• Stephanie Stupfel
• Martin Edward Sudar, LPTA
• Azhar Sultanova
• Jenae Michelle Summerour, LMT
• Kendra Joan Summers, PHD

• Physical Therapist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.