Individual provider Active NPI

Amy Elizabeth Negron, PTA, CMT

  • Physical Therapy Assistant
  • Milwaukie, OR
National Provider Identifier
1760145841
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA49510 Issued in CA
Practice address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone
(971) 206-5202
NPI assigned
Oct 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 62113 CA
Physical Therapy Assistant 225200000X PTA49510 CA Primary

Addresses

Primary practice location

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628

Mailing address

942 Shadow Tree CT
Vacaville, CA 95687-7709
Phone (530) 906-9450

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
62113CAMDDentist
PTA49510CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1760145841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 SHADOW TREE CT",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956877709",
            "telephone_number": "530-906-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRON",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "credential": "PTA, CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "62113",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA49510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.