Individual provider Active NPI

Michelle K Correia-Jeffers, DPT

  • Physical Therapist
  • Beaverton, OR
National Provider Identifier
1912565623
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
17323 SW Jay St
Beaverton, OR 97003-7626
Phone
(530) 638-5848
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

17323 SW Jay St
Beaverton, OR 97003-7626

Mailing address

16055 SW Walker Rd Ste 188
Beaverton, OR 97006-4942
Phone (530) 638-5848

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
Stable Body Physical Therapy Current Accepting new patients
Ultra Physical Therapy & Hand Center II LLC Physical Therapist PastSince May 1, 2022 Accepting new patients

Locations

16055 SW Walker Rd
Beaverton, OR 97006
Phone (503) 828-3402

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.

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1912565623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 SW WALKER RD STE 188",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064942",
            "telephone_number": "530-638-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17323 SW JAY ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970037626",
            "telephone_number": "530-638-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREIA-JEFFERS",
        "first_name": "MICHELLE",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.