Active NPI
Trevor Stephenson, P.T.
- Physical Therapist
- Beaverton, OR
National Provider Identifier
1578880134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4494
- Practice address
- 1960 NW 167TH PL Ste 200
Beaverton, OR 97006 - Phone
- (503) 413-4488
- Fax
- (503) 413-1812
- NPI assigned
- Apr 22, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 4494 | OR | Primary |
Addresses
Primary practice location
1960 NW 167TH PL Ste 200
Beaverton, OR 97006
Mailing address
PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900
Other practice location 1
4475 SW Scholls Ferry Rd Ste 258
Portland, OR 97225-1958
Phone (503) 292-5882
Other practice location 2
4475 SW Scholls Ferry Rd Ste 258
Portland, OR 97225-1958
Phone (503) 292-5882
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H & P Goodell, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Goodell Physical Therapy & Fitness Training
- Physical Therapy Clinic/Center
- Portland, OR
- NPI 1013908169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541116800000",
"number": "1578880134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3777",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083777",
"telephone_number": "503-413-3900",
"fax_number": "503-413-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 NW 167TH PL STE 200",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97006",
"telephone_number": "503-413-4488",
"fax_number": "503-413-1812"
}
],
"practiceLocations": [
{
"address_1": "4475 SW Scholls Ferry Rd Ste 258",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972251958",
"country_code": "US",
"telephone_number": "503-292-5882",
"fax_number": "503-292-5899",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4475 SW Scholls Ferry Rd Ste 258",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972251958",
"country_code": "US",
"telephone_number": "503-292-5882",
"fax_number": "503-292-5899",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEPHENSON",
"first_name": "TREVOR",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-22",
"last_updated": "2018-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "4494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.