Individual provider Active NPI

Jon Allan Schnepel, P.T.

  • Specialist
  • Gresham, OR
National Provider Identifier
1619950797
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1068 Issued in OR
Practice address
19201 SE Division St
Gresham, OR 97030-5227
Phone
(503) 669-2500
Fax
(503) 661-4113
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1068 OR Primary

Addresses

Primary practice location

19201 SE Division St
Gresham, OR 97030-5227

Mailing address

19201 SE Division St Ste 100
Gresham, OR 97030-5333
Phone (503) 669-2500

Other identifiers 1

IdentifierTypeStateIssuer
114907OtherORPTAN

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

LicenseStateTypeSpecialty
1068ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1619950797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19201 SE DIVISION ST STE 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305333",
            "telephone_number": "503-669-2500",
            "fax_number": "503-661-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19201 SE DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305227",
            "telephone_number": "503-669-2500",
            "fax_number": "503-661-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEPEL",
        "first_name": "JON",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "1068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "114907",
            "state": "OR"
        }
    ],
    "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 Mar 13, 2013; 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.