Active NPI
Glen Raymond Akers, PT
- Physical Therapist
- Gresham, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5023
- Practice address
- 25500 SE Stark St
Suite 103
Gresham, OR 97030-3331 - Phone
- (503) 328-0222
- Fax
- (503) 328-0223
- NPI assigned
- Apr 25, 2006
- Last updated
- Nov 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5023 | OR | Primary |
Addresses
Primary practice location
25500 SE Stark St
Suite 103
Gresham, OR 97030-3331
Mailing address
PO Box 52194
Dept Code 961
Phoenix, AZ 85072-2194
Phone (503) 328-0222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
25500 SE Stark St
Suite 103
Gresham, OR 97030-8327
Phone (503) 263-6786
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5023 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Proactive LLC | Physical Therapist | Current | Accepting new patients |
| Proactive Orthopedic and Sports Physical Therapy of Gresham LLC | Current | Accepting new patients | |
| Omnis Omnia Inc. | Past | Accepting new patients |
Locations
308 N Ivy St
Canby, OR 97013
Phone (503) 263-6786
1480 NE Village St
Fairview, OR 97024
Phone (503) 489-1174
25500 SE Stark St
Ste 103
Gresham, OR 97030
Phone (503) 263-6786
1630 Beavercreek Rd
Ste A
Oregon City, OR 97045
Phone (503) 607-0047
450 NW Greenwood Ave
Redmond, OR 97756
Phone (541) 923-0410
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba ProActive Physical Therapy
- Physical Therapy Clinic/Center
- Oregon City, OR
- NPI 1396273199
Physical Therapist
-
- Physical Therapy Clinic/Center
- Gresham, OR
- NPI 1467413179
-
dba Peak Performance Physical Therapy
- Orthopedic Physical Therapist
- Redmond, OR
- NPI 1013949239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226534400000",
"number": "1477519874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 52194",
"address_2": "DEPT CODE 961",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850722194",
"telephone_number": "503-328-0222",
"fax_number": "503-328-0223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25500 SE STARK ST",
"address_2": "SUITE 103",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303331",
"telephone_number": "503-328-0222",
"fax_number": "503-328-0223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AKERS",
"first_name": "GLEN",
"middle_name": "RAYMOND",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2008-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "5023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.