Active NPI
Michelle K Correia-Jeffers, DPT
- Physical Therapist
- Beaverton, OR
National Provider Identifier
1912565623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- 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
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 | 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stable Body Physical Therapy | Current | Accepting new patients | |
| Ultra Physical Therapy & Hand Center II LLC | Physical Therapist | Past | 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.
-
- Physical Therapy Clinic/Center
- Beaverton, OR
- NPI 1558143735
-
- Physical Therapy Clinic/Center
- Lake Oswego, OR
- NPI 1679218317
Physical Therapist
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.