Clackamas Sportscare LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CLACKAMAS SPORTSCARE LLC

Practice address

10121 SE Sunnyside Rd
Suite 208
Clackamas, OR 97015-5750

Phone

(503) 794-0103

Fax

(503) 794-0104

NPI assigned

Mar 1, 2007

Last updated

Jul 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ethan Benjamin Collier, DPTNPI 1740365238

Title

Doctor Physical Therapy Director

Phone

(503) 794-0103

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ethan Collier

  • Physical Therapist
  • Clackamas, OR
  • NPI 1740365238
  Authorized official Same address or phone
• Kristin Devoto, P.T.

  • Orthopedic Physical Therapist
  • Portland, OR
  • NPI 1811072945
  NPD
• Elisabeth M Berry

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Montgomery, TX
  • NPI 1851584726

  Physical Therapist

  NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1689702722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10121 SE SUNNYSIDE RD",
            "address_2": "SUITE 208",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155750",
            "telephone_number": "503-794-0103",
            "fax_number": "503-794-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 SE SUNNYSIDE RD",
            "address_2": "SUITE 208",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155750",
            "telephone_number": "503-794-0103",
            "fax_number": "503-794-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLACKAMAS SPORTSCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "DOCTOR PHYSICAL THERAPY DIRECTOR",
        "authorized_official_telephone_number": "503-794-0103",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clackamas Education Service District
• Clackamas Foot & Ankle Clinic
• Clackamas Foot & Ankle Clinic, Inc.
• Clackamas Physical Therapy Associates, Inc.
• Clackamas Radiation Oncology Center
• Clackamas Town Dental, LLC
• Ericha Clare, ND, LAC
• Amber Nicole Clark
• Matthew Harvey Clark, PA-C
• David D Clarke, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.

Verify at the official NPI Registry.