NPIMap

Organization Active NPI

North Lake Physical Therapy and Rehabilitation, Inc.

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1376810671
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.
Practice address
1420 NW 17TH Ave Ste 388
Portland, OR 97209-2447
Phone
(503) 222-4640
Fax
(503) 222-2730
NPI assigned
Nov 30, 2011
Last updated
Nov 30, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Michael Choate, MSPTNPI 1972571511
Title
President, North Lake Physical Ther
Phone
(503) 636-3028

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
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1420 NW 17TH Ave Ste 388
Portland, OR 97209-2447

Mailing address

101 S State St Ste 200G
Lake Oswego, OR 97034-3900
Phone (503) 636-3028

Other names 1

  • Kosta, Choate and Pierson, Inc. Former legal business name

National Provider Directory

National Provider Directory
Part of
North Lake PT and Rehab Inc

Locations

101 S State St
#200G
Lake Oswego, OR 97034
Phone (503) 636-3028

10466 SE Main St
Milwaukie, OR 97222
Phone (503) 353-9776

1715 Beavercreek Rd
Oregon City, OR 97045
Phone (503) 657-8553

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1376810671",
    "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": "1420 NW 17TH AVE STE 388",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092447",
            "telephone_number": "503-222-4640",
            "fax_number": "503-222-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "CHOATE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT, NORTH LAKE PHYSICAL THER",
        "authorized_official_telephone_number": "503-636-3028",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kosta, Choate and Pierson, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Nov 30, 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.