Active NPI
Jordon Whitaker, PT, DPT
- Physical Therapist
- Lake Oswego, OR
National Provider Identifier
1841780426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 62437
- Practice address
- 4811 Meadows Rd Ste 105
Lake Oswego, OR 97035-2542 - Phone
- (503) 387-6081
- NPI assigned
- May 18, 2018
- Sex
- Female
- 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 | 62437 | OR | Primary |
Addresses
Primary practice location
4811 Meadows Rd Ste 105
Lake Oswego, OR 97035-2542
Mailing address
1701 NE Sunset LN
Grants Pass, OR 97526-6405
Phone (541) 613-8814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62437 | OR | MD | Physical Therapist |
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.
-
- Orthopaedic Surgery Physician
- Tualatin, OR
- NPI 1568151561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1841780426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 NE SUNSET LN",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975266405",
"telephone_number": "541-613-8814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4811 MEADOWS RD STE 105",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970352542",
"telephone_number": "503-387-6081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITAKER",
"first_name": "JORDON",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-18",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "62437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.