Active NPI
Marcy Lynn Crouch, PT, DPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1578853958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH10253
- Practice address
- 4876 NW Bethany Blvd
Suite L-1
Portland, OR 97229-9259 - Phone
- (503) 466-2254
- Fax
- (503) 466-1143
- NPI assigned
- Apr 19, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 37785 | CA | |
| Physical Therapist | 225100000X | 60493 | OR | |
| Physical Therapist | 225100000X | PTH10253 | AL | Primary |
Addresses
Primary practice location
4876 NW Bethany Blvd
Suite L-1
Portland, OR 97229-9259
Mailing address
16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other practice location 1
1111 S College St Unit 200
Auburn, AL 36832-5984
Phone (334) 521-1610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500706471 | 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 |
|---|---|---|---|
| PTH10253 | AL | MD | Physical Therapist |
| 37785 | CA | MD | Physical Therapist |
| 60493 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benchmark Physical Therapy of Alabama, LLC | Physical Therapist | Current | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
| Benchmark Physical Therapy of Alabama, LLC | Physical Therapist | Past | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Auburn, AL
- NPI 1841950870
-
- Physical Therapist
- Portland, OR
- NPI 1700862000
-
- Physical Therapist
- Moody, AL
- NPI 1417386434
-
- Physical Therapist
- Bothell, WA
- NPI 1114376563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1578853958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD",
"address_2": "SUITE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "800-219-8835",
"fax_number": "503-639-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4876 NW BETHANY BLVD",
"address_2": "SUITE L-1",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972299259",
"telephone_number": "503-466-2254",
"fax_number": "503-466-1143"
}
],
"practiceLocations": [
{
"address_1": "1111 S College St Unit 200",
"address_purpose": "LOCATION",
"city": "Auburn",
"state": "AL",
"postal_code": "368325984",
"country_code": "US",
"telephone_number": "334-521-1610",
"fax_number": "334-833-1852",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CROUCH",
"first_name": "MARCY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2022-08-24",
"certification_date": "2022-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "37785",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "60493",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH10253",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500706471",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.