Mark Kevin Gumtang, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

64108 Issued in OR

Practice address

2512 SE 109TH Ave
Portland, OR 97266-1215

Phone

(503) 388-3755

NPI assigned

Jun 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Affordable Home Health Care Agency, Inc

  • Home Health Agency
  • Portland, OR
  • NPI 1710352026
  NPD

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1801463831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7067 SE BLANTON ST APT 5304",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971232701",
            "telephone_number": "808-282-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 SE 109TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661215",
            "telephone_number": "503-388-3755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2130 SE 96th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972162603",
            "country_code": "US",
            "telephone_number": "503-261-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUMTANG",
        "first_name": "MARK KEVIN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Gulyas, RN
• Quinn Linden Gumbiner, LMT
• Aika Shepard Gumboc, MD
• Christopher Allen Gumke, P.T.
• Laura Elise Gumpert
• Nilana Sowbagya Gunasekaran, M.D.
• Sara Gunden
• Taylor Nicole Gunderman, LMT
• Carrie L Gundermann, BA
• Amy Ruth Gunderson, BSN, RN

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.