Individual provider Active NPI

Christine A Krueger, P.T.

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1740206770
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1988 Issued in OR
Practice address
1630 SW Morrison St
Suite100
Portland, OR 97205-1916
Phone
(503) 227-7774
Fax
(503) 227-7548
NPI assigned
Jul 14, 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 Therapist 225100000X 1988 OR Primary

Addresses

Primary practice location

1630 SW Morrison St
Suite100
Portland, OR 97205-1916

Mailing address

345 NW 84TH PL
Portland, OR 97229-6775
Phone (503) 292-6148

Other names 1

  • Christine A Brandner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061012000134 OR Practitioner - Physical Therapist in Private Practice 8325044852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Portland Physical Therapy Clinic LLCGroup PAC ID 9335145861, 6 clinicians

Practice addresses (Care Compare)

1630 SW Morrison St
Suite 100
Portland, OR 97205-1916
Phone (503) 227-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1988ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Portland Physical Therapy Clinic LLC CurrentSince Apr 25, 2006 Accepting new patients

Locations

1630 SW Morrison St
Ste 100
Portland, OR 97205
Phone (503) 227-7774

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740206770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 NW 84TH PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296775",
            "telephone_number": "503-292-6148",
            "fax_number": "503-227-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SW MORRISON ST",
            "address_2": "SUITE100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051916",
            "telephone_number": "503-227-7774",
            "fax_number": "503-227-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "CHRISTINE",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "1988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "BRANDNER",
            "middle_name": "A",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.