Prokaleo Physical Therapy, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Legal business name

PROKALEO PHYSICAL THERAPY, LLC

Practice address

12120 SW Garden PL
Tigard, OR 97223-8264

Phone

(971) 256-8416

NPI assigned

Apr 18, 2019

Organization subpart

No

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

Authorized official

Name

Kurt Gilbertson, PT

Title

Owner

Phone

(480) 298-6351

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1447813084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 NE JEFFERSON ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971243183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12120 SW GARDEN PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238264",
            "telephone_number": "971-256-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROKALEO PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "GILBERTSON",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-298-6351",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467996983",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Tigard, OR
• Providers in Tigard, OR by specialty
• Orthopedic Physical Therapist in Oregon

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

Verify at the official NPI Registry.