Optimal Therapy for Kids, LLC

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

4469 Issued in OR

Legal business name

OPTIMAL THERAPY FOR KIDS, LLC

Practice address

1145 Rock Creek Dr S
Salem, OR 97306-2222

Phone

(503) 453-6335

NPI assigned

Oct 15, 2014

Last updated

Oct 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sascha Gervais, PT

Title

Owner/Physical Therapist

Phone

(503) 453-6335

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1790189025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 ROCK CREEK DR S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062222",
            "telephone_number": "503-453-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 ROCK CREEK DR S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062222",
            "telephone_number": "503-453-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL THERAPY FOR KIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "GERVAIS",
        "authorized_official_first_name": "SASCHA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "503-453-6335",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "OR",
            "license": "4469",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "306415",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nneoma Benedicta Oparaji, MD
• Magdaline Akudo Oparaochaekwe-Ebere, BEHAVIOR TECHNICIAN
• Open Path Psychology, LLC
• Kara L Opheim, DDS
• Kimberly Ruth Oppelt
• Optitune Physical Therapy, LLC
• Optometric Care of Oregon (All Family Vision Care)
• Optum Behavioral Care of Colorado, P.C.
• Or Oms Specialty Dental Services, LLC
• Or Oms Specialty Dental Services, LLC

• Pediatric Physical Therapist in Salem, OR
• Providers in Salem, OR by specialty
• Pediatric Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.