Active NPI
David Berris Standifer, PHYSICAL THERAPIST
- Physical Therapist
- Central Point, OR
National Provider Identifier
1922081876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1800
- Practice address
- 1249 Plaza Blvd
Suite F
Central Point, OR 97502-2670 - Phone
- (541) 664-2800
- Fax
- (541) 664-0555
- NPI assigned
- Nov 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1800 | OR | Primary |
| Physical Therapist | 225100000X | PT00003465 | WA |
Addresses
Primary practice location
1249 Plaza Blvd
Suite F
Central Point, OR 97502-2670
Mailing address
16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014345 | Medicaid | OR | |
| 650022829 | Other | OR | RAILROAD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1800 | OR | MD | Physical Therapist |
| PT00003465 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Bothell, WA
- NPI 1114376563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352678400000",
"number": "1922081876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD",
"address_2": "STE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "800-219-8835",
"fax_number": "503-639-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1249 PLAZA BLVD",
"address_2": "SUITE F",
"city": "CENTRAL POINT",
"state": "OR",
"postal_code": "975022670",
"telephone_number": "541-664-2800",
"fax_number": "541-664-0555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANDIFER",
"first_name": "DAVID",
"middle_name": "BERRIS",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2012-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "1800",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00003465",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014345",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "650022829",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Central Point, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.