Jamison Keith Carroll, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

447328 Issued in OR

Practice address

9370 SW Greenburg Rd
Portland, OR 97223-5442

Phone

(503) 200-5750

NPI assigned

Jan 23, 2021

Last updated

Feb 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ultra Physical Therapy & Hand Center II LLC

  • Physical Therapy Clinic/Center
  • Lake Oswego, OR
  • NPI 1679218317

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1568052595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11683 SW TEAL BLVD APT M",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970077969",
            "telephone_number": "435-213-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9370 SW GREENBURG RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235442",
            "telephone_number": "503-200-5750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2217 Country Club Rd",
            "address_purpose": "LOCATION",
            "city": "Woodburn",
            "state": "OR",
            "postal_code": "970712811",
            "country_code": "US",
            "telephone_number": "503-982-4200",
            "fax_number": "503-981-2323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11683 SW Teal Blvd Apt M",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970077969",
            "country_code": "US",
            "telephone_number": "435-213-6134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8995 SW Miley Rd",
            "address_purpose": "LOCATION",
            "city": "Wilsonville",
            "state": "OR",
            "postal_code": "970705484",
            "country_code": "US",
            "telephone_number": "503-694-8366",
            "fax_number": "503-694-8581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JAMISON",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-23",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "447328",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-008360",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Carroll, PA-C
• Debra Lynn Carroll, RPH
• Fay Kaleinani Carroll
• Gregory Carroll, RN, BSN
• Hannah Carroll
• Jessica Anne Carroll
• Jessica Graham Carroll, CRNA
• Kari D Carroll, MS
• Kevin H. Carroll, M.D.
• McKenna Carroll, M.A., LBA, BCBA

• Occupational Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.