Active NPI
Cheryl Sherwood Kosta, P.T.
- Physical Therapist
- Lake Oswego, OR
National Provider Identifier
1548238165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1418
- Practice address
- 101 S State St
Suite 200G
Lake Oswego, OR 97034-3900 - Phone
- (503) 636-3028
- Fax
- (503) 636-1837
- NPI assigned
- Mar 9, 2006
- Last updated
- May 9, 2008
- Sex
- Female
- 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 | 1418 | OR | Primary |
Addresses
Primary practice location
101 S State St
Suite 200G
Lake Oswego, OR 97034-3900
Mailing address
101 S State St
Suite 200G
Lake Oswego, OR 97034-3900
Phone (503) 636-3028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20461 | Medicaid | OR |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1418 | OR | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Oregon Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
| North Lake Physical Therapy and Rehabilitation, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Lake Oswego, OR
- NPI 1841345352
-
- Physical Therapist
- La Grande, OR
- NPI 1679907281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210291200000",
"number": "1548238165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S STATE ST",
"address_2": "SUITE 200G",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970343900",
"telephone_number": "503-636-3028",
"fax_number": "503-636-1837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S STATE ST",
"address_2": "SUITE 200G",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970343900",
"telephone_number": "503-636-3028",
"fax_number": "503-636-1837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSTA",
"first_name": "CHERYL",
"middle_name": "SHERWOOD",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-09",
"last_updated": "2008-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "1418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20461",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.