Individual provider Active NPI

Bryan Gregory Gerhard, CPO, LCPO

  • Prosthetist
  • Shoreline, WA
National Provider Identifier
1790318376
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Practice address
15225 Aurora Ave N
Shoreline, WA 98133-6123
Phone
(206) 363-7790
Fax
(206) 363-7688
NPI assigned
Feb 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X
Prosthetist 224P00000X Primary

Addresses

Primary practice location

15225 Aurora Ave N
Shoreline, WA 98133-6123

Mailing address

15225 Aurora Ave N
Shoreline, WA 98133-6123
Phone (206) 363-7790

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

Practice roles

OrganizationSpecialtyStatusNew patients
Douglass Cert Pros & Orthotics, Inc Orthotist CurrentSince Feb 1, 2020 Accepting new patients

Locations

10740 Meridian Ave N
Ste G2
Seattle, WA 98133
Phone (206) 363-7790

15225 Aurora Ave N
Shoreline, WA 98133
Phone (206) 363-7790

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": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1790318376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336123",
            "telephone_number": "206-363-7790",
            "fax_number": "206-363-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336123",
            "telephone_number": "206-363-7790",
            "fax_number": "206-363-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERHARD",
        "first_name": "BRYAN",
        "middle_name": "GREGORY",
        "credential": "CPO, LCPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-21",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.