NPIMap

Organization Active NPI

Advance Injury Care and Movement Therapy LLC

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1386924934
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
9601 Issued in OR
Legal business name
ADVANCE INJURY CARE AND MOVEMENT THERAPY LLC
Practice address
11507 SW Shilo LN
Ste E
Portland, OR 97225-5923
Phone
(503) 939-2524
Fax
(503) 520-0514
NPI assigned
Aug 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Authorized official

Name
Mr. Richard Walter Roskopf, LMTNPI 1982724795
Title
Owner
Phone
(503) 939-2524

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
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 9601 OR Primary

Addresses

Primary practice location

11507 SW Shilo LN
Ste E
Portland, OR 97225-5923

Mailing address

11507 SW Shilo LN
Ste E
Portland, OR 97225-5923
Phone (503) 939-2524

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1386924934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11507 SW SHILO LN",
            "address_2": "STE E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255923",
            "telephone_number": "503-939-2524",
            "fax_number": "503-520-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11507 SW SHILO LN",
            "address_2": "STE E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255923",
            "telephone_number": "503-939-2524",
            "fax_number": "503-520-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE INJURY CARE AND MOVEMENT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "ROSKOPF",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-939-2524",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "9601",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 26, 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.