Active NPI
Amy Brown, LMT, PTA, CSCS
- Physical Therapist
- Portland, OR
National Provider Identifier
1801906540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 625 NW 17TH Ave
Portland, OR 97209-2209 - Phone
- (503) 980-5712
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Health Educator | 174H00000X | 19726 | OR |
Addresses
Primary practice location
625 NW 17TH Ave
Portland, OR 97209-2209
Mailing address
1010 NW Naito Pkwy
M16
Portland, OR 97209-3768
Phone (503) 980-5712
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8072 | Other | OR | LICENSE # |
| 19726 | Other | OR | LMT |
| 8072 | Other | OR | PHYSICAL THERAPISTS ASSISTANT |
| 7247825326 | Other | CERTIFIED STRENGTH & CONDITIONING SPECIALIST |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19726 | OR | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382313600000",
"number": "1801906540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 NW NAITO PKWY",
"address_2": "M16",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093768",
"telephone_number": "503-980-5712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 NW 17TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972092209",
"telephone_number": "503-980-5712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "AMY",
"name_prefix": "Miss",
"credential": "LMT, PTA, CSCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2013-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "OR",
"license": "19726",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "8072",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMT",
"identifier": "19726",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPISTS ASSISTANT",
"identifier": "8072",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED STRENGTH & CONDITIONING SPECIALIST",
"identifier": "7247825326",
"state": null
}
],
"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 Oct 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.