Mary Kristine Sipple, L.PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

7677 Issued in OR

Practice address

3270 Liberty Rd S
Salem, OR 97302

Phone

(503) 371-0779

Fax

(503) 371-0886

NPI assigned

Aug 19, 2011

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

Other names 1

• Mary Kristine Southam Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Northwest Rehabilitation Associates, Inc.

  • Physical Therapy Clinic/Center
  • West Salem, OR
  • NPI 1972505790
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1346520442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-371-0779",
            "fax_number": "503-371-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-371-0779",
            "fax_number": "503-371-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPPLE",
        "first_name": "MARY",
        "middle_name": "KRISTINE",
        "credential": "L.PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "7677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SOUTHAM",
            "middle_name": "KRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sumit Singhal, M.D
• Kendra Sinn
• Tyron James Sinn, PHARMD
• Sinuclear Oregon PC
• Marjorie Bekki Sipe
• Brianne Elizabeth Sischo, LPN
• Purcell Sisto, QMHP, CADC-II
• Jean Kathryn Sitkei, PT
• Sara Cowart Sitz, ST
• Lauren Gabrielle Siverly

• Physical Therapy Assistant in Salem, OR
• Providers in Salem, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.