Individual provider Active NPI

Elizabeth Ellen Fuegy, LMT

  • Mechanotherapist
  • Portland, OR
National Provider Identifier
1649516238
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
9828672 Issued in OR
Practice address
20 SW Custer Street
Portland, OR 97219-2900
Phone
(503) 351-2973
NPI assigned
Dec 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 9828672 OR Primary

Addresses

Primary practice location

20 SW Custer Street
Portland, OR 97219-2900

Mailing address

20 SW Custer St
Portland, OR 97219-2900
Phone (503) 351-2973

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9828672ORMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1649516238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SW CUSTER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972192900",
            "telephone_number": "503-351-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SW CUSTER STREET",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972192900",
            "telephone_number": "503-351-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUEGY",
        "first_name": "ELIZABETH",
        "middle_name": "ELLEN",
        "name_prefix": "Miss",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-31",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "9828672",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 31, 2012; 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.