Active NPI
Shawn Vindel Dailey, PT
- Physical Therapist
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5000
- Practice address
- 4829 NE Martin Luther King Blvd
Ste 101
Portland, OR 97211-3351 - Phone
- (503) 283-8133
- Fax
- (503) 289-2312
- NPI assigned
- Nov 25, 2005
- Sex
- Male
- Sole proprietor
- No
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 | 5000 | OR | Primary |
Addresses
Primary practice location
4829 NE Martin Luther King Blvd
Ste 101
Portland, OR 97211-3351
Mailing address
16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 213465 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20055 SW Pacific Hwy
Suite 110
Sherwood, OR 97140-9294
Phone (503) 625-1691
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5000 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Associates Inc | Physical Therapist | Current | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Current | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Current | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
Locations
16315 SW Barrows Rd
Ste 205
Beaverton, OR 97007
Phone (503) 521-0500
4829 NE Mlk Jr Blvd
Ste 101
Portland, OR 97211
Phone (503) 283-8133
1307 NE 102nd Ave
Ste G
Portland, OR 97220
Phone (503) 253-0924
20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691
16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153
Interoperability endpoints
- shawn.dailey.1@31414.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Physical Therapist
- Ashland, OR
- NPI 1972589364
-
- Physical Therapist
- Portland, OR
- NPI 1144042649
-
- Physical Therapist
- Portland, OR
- NPI 1891771234
-
- Physical Therapist
- Portland, OR
- NPI 1700862000
-
- Physical Therapist
- Bothell, WA
- NPI 1114376563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351814400000",
"number": "1801879614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD",
"address_2": "STE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "800-219-8835",
"fax_number": "503-639-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4829 NE MARTIN LUTHER KING BLVD",
"address_2": "STE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972113351",
"telephone_number": "503-283-8133",
"fax_number": "503-289-2312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAILEY",
"first_name": "SHAWN",
"middle_name": "VINDEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-25",
"last_updated": "2012-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "5000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "213465",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.