Active NPI
Shai Sewell, DPT
- Physical Therapist
- Clackamas, OR
National Provider Identifier
1760160881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 64998
- Practice address
- 10180 SE Sunnyside Rd
Clackamas, OR 97015-8970 - Phone
- (503) 813-2000
- NPI assigned
- Jul 10, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | 64998 | OR | Primary |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Mailing address
3402 NW 2ND St
Gainesville, FL 32609-2270
Phone (415) 299-2086
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 |
|---|---|---|---|
| 64998 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1760160881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3402 NW 2ND ST",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326092270",
"telephone_number": "415-299-2086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10180 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970158970",
"telephone_number": "503-813-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEWELL",
"first_name": "SHAI",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "OR",
"license": "64998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.