Active NPI
Michael Jhon, PTA
- Physical Therapy Assistant
- Milwaukie, OR
National Provider Identifier
1669546446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT4055
- Practice address
- 4560 SE International Way
Suite 100
Milwaukie, OR 97222 - Phone
- (971) 206-5140
- Fax
- (971) 206-5209
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | AT4055 | CA | Primary |
Addresses
Primary practice location
4560 SE International Way
Suite 100
Milwaukie, OR 97222
Mailing address
513 Lexington Ave
El Cerrito, CA 94530
Phone (510) 527-5303
Other names 1
- Mr. Michael John Irwin
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 |
|---|---|---|---|
| AT4055 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669546446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 LEXINGTON AVE",
"city": "EL CERRITO",
"state": "CA",
"postal_code": "94530",
"telephone_number": "510-527-5303",
"fax_number": "510-527-3150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "SUITE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5140",
"fax_number": "971-206-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JHON",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT4055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHAEL",
"last_name": "IRWIN",
"middle_name": "JOHN",
"prefix": "MR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.