Active NPI
Kaitlin Willoughby Berger, L.M.T.
- Rehabilitation Chiropractor
- Portland, OR
National Provider Identifier
1689945289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- LMT# 18506
- Practice address
- 118 N Killingsworth St
Portland, OR 97217-2435 - Phone
- (503) 288-4454
- Fax
- (503) 288-1783
- NPI assigned
- Jan 13, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | LMT# 18506 | OR | Primary |
Addresses
Primary practice location
118 N Killingsworth St
Portland, OR 97217-2435
Mailing address
513 NE Webster St
Portland, OR 97211-3807
Phone (786) 473-3854
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18506 | Other | OR | LMT |
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 |
|---|---|---|---|
| LMT# 18506 | OR | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326412800000",
"number": "1689945289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 NE WEBSTER ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972113807",
"telephone_number": "786-473-3854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 N KILLINGSWORTH ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972172435",
"telephone_number": "503-288-4454",
"fax_number": "503-288-1783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGER",
"first_name": "KAITLIN",
"middle_name": "WILLOUGHBY",
"credential": "L.M.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-13",
"last_updated": "2012-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "OR",
"license": "LMT# 18506",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMT",
"identifier": "18506",
"state": "OR"
}
],
"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 Jan 13, 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.