Active NPI
Elizabeth Henderson, DPT
- Physical Therapist
- Oregon City, OR
National Provider Identifier
1346800661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 63268
- Practice address
- 1630 Beavercreek Rd Ste a
Oregon City, OR 97045-4156 - Phone
- (503) 607-0047
- Fax
- (503) 607-0051
- NPI assigned
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 63268 | OR | Primary |
Addresses
Primary practice location
1630 Beavercreek Rd Ste a
Oregon City, OR 97045-4156
Mailing address
1480 NE Village St
Fairview, OR 97024-3827
Phone (503) 489-1174
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 |
|---|---|---|---|
| 63268 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omnis Omnia Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Peak Performance Physical Therapy
- Orthopedic Physical Therapist
- Redmond, OR
- NPI 1013949239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1346800661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1480 NE VILLAGE ST",
"city": "FAIRVIEW",
"state": "OR",
"postal_code": "970243827",
"telephone_number": "503-489-1174",
"fax_number": "503-489-1650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 BEAVERCREEK RD STE A",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970454156",
"telephone_number": "503-607-0047",
"fax_number": "503-607-0051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "ELIZABETH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-18",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "63268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oregon City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.