Kaylan Taylor Stayton, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15540 Issued in TN

Practice address

3016 NE Broadway St
Portland, OR 97232-1811

Phone

(503) 287-6636

NPI assigned

Mar 13, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Broadway Physical Therapy and Sports Rehab LLCGroup PAC ID 4183610611, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Broadway Physical Therapy & Sports Rehab LLC

  • Specialist
  • Portland, OR
  • NPI 1326185950
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1629837638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13885 SW MERIDIAN ST UNIT 132",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052481",
            "telephone_number": "901-483-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321811",
            "telephone_number": "503-287-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAYTON",
        "first_name": "KAYLAN",
        "middle_name": "TAYLOR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "15540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton Donald Stave
• Johanka Stavenik, OTR/L
• Kori Stavig, LMT
• Mary F Stavropoulos, D.D.S.
• Melissa Stawarz, RD, LD
• Stayunbroken, LLC
• Taylor Howland Stclair, DACCHM, MSIMH
• Allyndreth Stead, L.AC.
• Angela Stearns, M. D.
• Sarah D Stearns, PHARM.D.

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.