Pedal PT, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

4465 Issued in OR

Legal business name

PEDAL PT, LLC

Doing business as

Pedal PT

Practice address

2622 SE 25TH Ave
Suite B
Portland, OR 97202-1217

Phone

(503) 453-4993

NPI assigned

Jul 20, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Schmidt, MSPT, CMPNPI 1811039035

Title

Physical Therapist, Owner

Phone

(503) 453-4993

Specialties & licenses 1

Addresses

Other names 1

• Pedal PT Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin A Schmidt, M.S.P.T.

  • Orthopedic Physical Therapist
  • Portland, OR
  • NPI 1811039035
  Authorized official Same address or phone

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1578818951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 SE 65TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061201",
            "telephone_number": "503-453-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 SE 25TH AVE",
            "address_2": "SUITE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021217",
            "telephone_number": "503-453-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDAL PT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "503-453-4993",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT, CMP"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "4465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pedal PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Grace Peck, BA
• Regina Peck
• Eli Peckham, ATC
• Scott Westley Pecora, N.P.
• Anders Pecore
• Ali Elizabeth Pedego, PH.D., BCBA-D
• Marisa Quijano Peden, LMT
• Andrew Dale Pedersen, M.D.
• Eizabeth Michele Pedersen, LMT
• Joni Pedersen

• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.