Individual provider Active NPI

Mary Eileen Shearer, PHYSICAL THERAPIST A

  • Physical Therapy Assistant
  • Forest Grove, OR
National Provider Identifier
1700893203
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
7632 Issued in OR
Practice address
2333 Pacific Ave
Forest Grove, OR 97116
Phone
(503) 359-6145
Fax
(503) 359-6919
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 7632 OR Primary

Addresses

Primary practice location

2333 Pacific Ave
Forest Grove, OR 97116

Mailing address

51142 N W Strohmayer Rd
Forest Grove, OR 97116
Phone (971) 970-5537

Other names 1

  • Mary Eileen Harris Former name

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
7632ORMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tuality Healthcare Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700893203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51142 N W STROHMAYER RD",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "97116",
            "telephone_number": "971-970-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 PACIFIC AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "97116",
            "telephone_number": "503-359-6145",
            "fax_number": "503-359-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "MARY",
        "middle_name": "EILEEN",
        "credential": "PHYSICAL THERAPIST A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "7632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HARRIS",
            "middle_name": "EILEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Forest Grove, 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.

Verify at the official NPI Registry.