Active NPI
Jeff Conlon, PTA
- Physical Therapy Assistant
- Portland, OR
National Provider Identifier
1861716003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 09414
- Practice address
- 11795 NW Cedar Falls Dr
Portland, OR 97229-2786 - Phone
- (503) 350-3400
- NPI assigned
- Mar 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 09414 | OR | Primary |
Addresses
Primary practice location
11795 NW Cedar Falls Dr
Portland, OR 97229-2786
Mailing address
8100 SW Nyberg St Ste 200
Tualatin, OR 97062-8437
Phone (503) 570-3665
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 |
|---|---|---|---|
| 09414 | OR | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exum Chiropractic Clinic, P.a. | Past | Accepting new patients | |
| Health 1St Medical and Rehabilitation LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- Orlando, FL
- NPI 1912179680
-
- Nurse Practitioner
- Winter Garden, FL
- NPI 1578806766
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683244800000",
"number": "1861716003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 SW NYBERG ST STE 200",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970628437",
"telephone_number": "503-570-3665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11795 NW CEDAR FALLS DR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972292786",
"telephone_number": "503-350-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLON",
"first_name": "JEFF",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-17",
"last_updated": "2023-05-05",
"certification_date": "2023-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OR",
"license": "09414",
"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 May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.