Individual provider Active NPI

Amy Brown, LMT, PTA, CSCS

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1801906540
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
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

Updated by the provider on Oct 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
8072OtherORLICENSE #
19726OtherORLMT
8072OtherORPHYSICAL THERAPISTS ASSISTANT
7247825326OtherCERTIFIED 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

LicenseStateTypeSpecialty
19726ORMDHealth 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.

Verify at the official NPI Registry.