Addison Brown Wise, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

63573 Issued in OR

Practice address

1554 Garden St Ste 103
West Linn, OR 97068-3278

Phone

(503) 723-0347

NPI assigned

Feb 7, 2020

Last updated

May 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Addison Brown Former name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Motion PLLCGroup PAC ID 6103071014, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peak Motion, PLLC

  dba Fyzical Therapy & Balance Centers

  • Physical Therapy Clinic/Center
  • Camas, WA
  • NPI 1588916894

  OR, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1790317758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SE 192ND AVE STE 109",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077415",
            "telephone_number": "360-210-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 GARDEN ST STE 103",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683278",
            "telephone_number": "503-723-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ADDISON",
        "middle_name": "BROWN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADDISON",
            "last_name": "BROWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willamette Pain and Spine Center, PC
• Willamette Procedure Center PC
• Kelly Anne Williams, RN
• Anne Marie Wilson, RN
• Megan Nichole Wimberly, FNP-BC
• Adria Withrow
• Karoline Woitke, PA-C
• Lisa S Wolf, OTR/L
• Jamie Lynn Woodley, LMT
• Wright Counseling & Consultation Services, LLC

• Physical Therapist in West Linn, OR
• Providers in West Linn, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.