NPIMap

Organization Active NPI

Cascade 205 Orthopedic and Sports Physical Therapy, PC

  • Preferred Provider Organization
  • Portland, OR
National Provider Identifier
1356348106
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
2319 Issued in OR
Legal business name
CASCADE 205 ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, PC
Practice address
9260 SE Stark St
Suite B
Portland, OR 97216-1640
Phone
(503) 255-1500
Fax
(503) 255-1560
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Authorized official

Name
Julie McAllister, MSPTNPI 1114908571
Title
Owner/Director/Therapist
Phone
(503) 255-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 2319 OR Primary

Addresses

Primary practice location

9260 SE Stark St
Suite B
Portland, OR 97216-1640

Mailing address

9260 SE Stark St
Suite B
Portland, OR 97216-1640
Phone (503) 255-1500

Other identifiers 1

IdentifierTypeStateIssuer
297214MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414001677 OR Part B Supplier - Clinic/Group Practice 3072508670 Receives reassigned benefits from 3 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

9310 SE Stark St
Portland, OR 97216
Phone (503) 255-1500

9260 SE Stark St
Ste B
Portland, OR 97216
Phone (503) 255-1500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1356348106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 SE STARK ST",
            "address_2": "SUITE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972161640",
            "telephone_number": "503-255-1500",
            "fax_number": "503-255-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9260 SE STARK ST",
            "address_2": "SUITE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972161640",
            "telephone_number": "503-255-1500",
            "fax_number": "503-255-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE 205 ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR/THERAPIST",
        "authorized_official_telephone_number": "503-255-1500",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OR",
            "license": "2319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297214",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.