Individual provider Active NPI

Joseph John Fricke, PT

  • Orthopedic Physical Therapist
  • Portland, OR
National Provider Identifier
1851350870
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1660 Issued in OR
Practice address
11300 NE Halsey St
Suite 102
Portland, OR 97220-2096
Phone
(503) 257-9881
Fax
(503) 257-8964
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1660 OR Primary

Addresses

Primary practice location

11300 NE Halsey St
Suite 102
Portland, OR 97220-2096

Mailing address

11300 NE Halsey St
Suite 102
Portland, OR 97220-2096
Phone (503) 257-9881

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Parkrose Sports Care PT LLC CurrentSince Aug 24, 1999 Accepting new patients
Sportscare Physical Therapy @ Cornell, LLC CurrentSince Jul 1, 2018 Accepting new patients
Sportscare Physical Therapy @ Cornell, LLC CurrentSince Jul 1, 2018 Accepting new patients
Ryan Douglas Glover Armworks Hand Therapy Past Accepting new patients
Ryan Douglas Glover Armworks Hand Therapy Past Accepting new patients
Sandy Sportscare Physical Therapy LLC Orthopedic PastSince Sep 16, 2019 Accepting new patients

Locations

16100 NW Cornell Rd
Ste 110
Beaverton, OR 97006
Phone (971) 245-6663

10121 SE Sunnyside Rd
Ste 208
Clackamas, OR 97015
Phone (503) 427-2956

10748 NE Halsey St
Portland, OR 97220
Phone (503) 257-9881

11300 NE Halsey St
Ste 102
Portland, OR 97220
Phone (503) 257-9881

3871 Fairview Industrial Dr SE
Ste 120
Salem, OR 97302
Phone (503) 990-6393

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1851350870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 NE HALSEY ST",
            "address_2": "SUITE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202096",
            "telephone_number": "503-257-9881",
            "fax_number": "503-257-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 NE HALSEY ST",
            "address_2": "SUITE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202096",
            "telephone_number": "503-257-9881",
            "fax_number": "503-257-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "1660",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 31, 2007; 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.