Endeavor Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4180650-98 Issued in OR

Legal business name

ENDEAVOR PHYSICAL THERAPY, INC.

Practice address

19856 SE Highway 212
Damascus, OR 97089-5743

Phone

(417) 559-2627

Fax

(503) 386-2745

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Brian T SundahlNPI 1790729952

Title

President

Phone

(417) 559-2627

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 3

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

• Brian T Sundahl, DPT

  • Physical Therapist
  • Damascus, OR
  • NPI 1790729952

  OR

  Medicare reassignment Care Compare group Authorized official
• Kordell Lewis McPherson, DPT

  • Physical Therapist
  • Sandy, OR
  • NPI 1033845953

  OR, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Stormy Gail Trujillo, LMT

  • Massage Therapist
  • Gresham, OR
  • NPI 1235083767
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1457577553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19856 SE HIGHWAY 212",
            "city": "DAMASCUS",
            "state": "OR",
            "postal_code": "970895743",
            "telephone_number": "417-559-2627",
            "fax_number": "503-386-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19856 SE HIGHWAY 212",
            "city": "DAMASCUS",
            "state": "OR",
            "postal_code": "970895743",
            "telephone_number": "417-559-2627",
            "fax_number": "503-386-2745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "372 South Broadway",
            "address_purpose": "LOCATION",
            "city": "Estacada",
            "state": "OR",
            "postal_code": "97023",
            "country_code": "US",
            "telephone_number": "503-630-5314",
            "fax_number": "503-630-5315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENDEAVOR PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "SUNDAHL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-559-2627"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4180650-98",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Damascus",
            "affiliation": "N",
            "address_1": "19856 SE Highway 212",
            "city": "Damascus",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970895743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cheryl Dene Davidson, CRNFA FNP-C
• Ryan Davis
• Beverly Ann De la Bruere
• Jessi Nicole Dixon Veras, RN BSN
• Thomas Dale Dutcher, D.C.
• Eyoelrth LLC
• George J Faris
• Janet Lee Gassman
• Summer Gerke
• Erin Page Giusto, LMT

• All providers in Damascus, OR
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.