Active NPI
Ingrid Emata
- Geriatric Physical Therapist
- Medford, OR
National Provider Identifier
1649662958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 60047
- Practice address
- 760 Spring St
Medford, OR 97504-6131 - Phone
- (541) 773-7718
- NPI assigned
- Feb 23, 2015
- Last updated
- Feb 23, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 60047 | OR | Primary |
Addresses
Primary practice location
760 Spring St
Medford, OR 97504-6131
Mailing address
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60047 | OR | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424649600000",
"number": "1649662958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE STE D",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 SPRING ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046131",
"telephone_number": "541-773-7718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMATA",
"first_name": "INGRID",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-23",
"last_updated": "2015-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "OR",
"license": "60047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.