Individual provider Active NPI

Ryan Douglas Glover, OTR/L, CHT

  • Hand Occupational Therapist
  • Gresham, OR
National Provider Identifier
1568413847
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
1041100414 Issued in OR
Practice address
24076 SE Stark St
Ste 200
Gresham, OR 97030-3373
Phone
(503) 491-1666
Fax
(503) 491-1667
NPI assigned
May 12, 2006
Last updated
Jan 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1023386 OR
Hand Occupational Therapist 225XH1200X 1041100414 OR Primary

Addresses

Primary practice location

24076 SE Stark St
Ste 200
Gresham, OR 97030-3373

Mailing address

PO Box 2485
Gresham, OR 97030-0660
Phone (503) 674-7860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060425000022 OR Practitioner - Occupational Therapist in Private Practice 8224048137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10121 SE Sunnyside Rd
Suite 208
Clackamas, OR 97015-5750
Phone (503) 794-0103

16100 NW Cornell Rd
Suite 110
Beaverton, OR 97006-7369
Phone (971) 245-6663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1023386ORMDOccupational Therapist
1041100414ORMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Armworks Hand Therapy, LLC CurrentSince Jan 1, 2006 Accepting new patients
Sportscare Physical Therapy @ Cornell, LLC Occupational Therapist CurrentSince Apr 1, 2024 Accepting new patients
Sportscare Physical Therapy @ Cornell, LLC CurrentSince Apr 1, 2024 Accepting new patients
Armworks Hand Therapy, LLC Occupational Therapist CurrentSince Jan 1, 2012 Accepting new patients
Ryan Douglas Glover Armworks Hand Therapy Hand PastSince Jan 1, 2006 Accepting new patients

Locations

15390 NW Cornell Rd
Ste 230
Beaverton, OR 97006
Phone (971) 245-0103

16100 NW Cornell Rd
Ste 110
Beaverton, OR 97006
Phone (971) 245-6663

10121 SE Sunnyside Rd
Ste 208
Clackamas, OR 97015
Phone (503) 427-2956

9100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 659-3846

24076 SE Stark St
Ste 200
Gresham, OR 97030
Phone (503) 491-1666

10748 NE Halsey St
Portland, OR 97220
Phone (503) 257-9881

3871 Fairview Industrial Dr SE
Ste 120
Salem, OR 97302
Phone (503) 990-6393

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231200000000",
    "number": "1568413847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2485",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970300660",
            "telephone_number": "503-674-7860",
            "fax_number": "503-674-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-491-1666",
            "fax_number": "503-491-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "RYAN",
        "middle_name": "DOUGLAS",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2009-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1023386",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "OR",
            "license": "1041100414",
            "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 Jan 6, 2009; 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.

Verify at the official NPI Registry.