Active NPI
Stephen Born, PT
- Physical Therapist
- Tigard, OR
National Provider Identifier
1528425261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3602
- Practice address
- 10450 SW McDonald St
Apt 61
Tigard, OR 97224-4814 - Phone
- (971) 222-8178
- NPI assigned
- Jan 26, 2016
- Last updated
- Jan 26, 2016
- 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 | 3602 | OR | Primary |
Addresses
Primary practice location
10450 SW McDonald St
Apt 61
Tigard, OR 97224-4814
Mailing address
10450 SW McDonald St
Apt 61
Tigard, OR 97224-4814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3602 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453766400000",
"number": "1528425261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10450 SW MCDONALD ST",
"address_2": "APT 61",
"city": "TIGARD",
"state": "OR",
"postal_code": "972244814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10450 SW MCDONALD ST",
"address_2": "APT 61",
"city": "TIGARD",
"state": "OR",
"postal_code": "972244814",
"telephone_number": "971-222-8178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORN",
"first_name": "STEPHEN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-26",
"last_updated": "2016-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "3602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.