Active NPI
Michelle Kay Kershaw, D.P.T.
- Physical Therapist
- Newberg, OR
National Provider Identifier
1730387960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5450
- Practice address
- 120-C N Everest Rd
Newberg, OR 97132-2116 - Phone
- (503) 538-8952
- Fax
- (503) 537-2027
- NPI assigned
- Jul 10, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5450 | OR | Primary |
Addresses
Primary practice location
120-C N Everest Rd
Newberg, OR 97132-2116
Mailing address
7348 SW 204TH #3
Aloha, OR 97007-7946
Phone (503) 642-7401
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5450 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pearls Counseling LLC | Past | Accepting new patients | |
| Chehalem Physical Therapy, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Newberg, OR
- NPI 1164497111
-
- Clinical Social Worker
- Newberg, OR
- NPI 1013325497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1730387960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7348 SW 204TH #3",
"city": "ALOHA",
"state": "OR",
"postal_code": "970077946",
"telephone_number": "503-642-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120-C N EVEREST RD",
"city": "NEWBERG",
"state": "OR",
"postal_code": "971322116",
"telephone_number": "503-538-8952",
"fax_number": "503-537-2027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSHAW",
"first_name": "MICHELLE",
"middle_name": "KAY",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "5450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newberg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.