Individual provider Active NPI

Kristin L McVay, MSPT

  • Geriatric Physical Therapist
  • Newberg, OR
National Provider Identifier
1629237029
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
4461 Issued in OR
Practice address
1900 Fulton St
Newberg, OR 97132-1806
Phone
(503) 538-2108
Fax
(503) 538-1768
NPI assigned
Jun 2, 2008
Last updated
Jun 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 4461 OR Primary

Addresses

Primary practice location

1900 Fulton St
Newberg, OR 97132-1806

Mailing address

1900 Fulton St
Newberg, OR 97132-1806
Phone (503) 538-2108

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120727000439 OR Practitioner - Physical Therapist in Private Practice 3476719956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TSL Well LLCGroup PAC ID 0345776050, 11 clinicians

Practice addresses (Care Compare)

3900 Kruse Way PL
Lake Oswego, OR 97035-2512
Phone (503) 635-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4461ORMDIntegrative Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premere Rehab LLC CurrentSince Sep 1, 2012 Accepting new patients
Premere Rehab LLC CurrentSince Sep 1, 2012 Accepting new patients
TSL Well LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

13160 SE 172nd Ave
Happy Valley, OR 97086
Phone (503) 563-4930

3330 SE Three Mile Ln
McMinnville, OR 97128
Phone (971) 645-1650

822 Golf View Dr
Medford, OR 97504
Phone (541) 774-1822

8100 SW Nyberg St
Ste 200
Tualatin, OR 97062
Phone (360) 901-8111

25117 SW Parkway Ave
Ste D
Wilsonville, OR 97070
Phone (888) 757-3422

Organizations & group practices 3

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1629237029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 FULTON ST",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321806",
            "telephone_number": "503-538-2108",
            "fax_number": "503-538-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 FULTON ST",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321806",
            "telephone_number": "503-538-2108",
            "fax_number": "503-538-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCVAY",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "OR",
            "license": "4461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.