Active NPI
Kerry Lynn Haugh, DPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1972600757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4406
- Practice address
- 707 SW Gaines St
Portland, OR 97239-2901 - Phone
- (800) 452-3563
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 4406 | OR | Primary |
Addresses
Primary practice location
707 SW Gaines St
Portland, OR 97239-2901
Mailing address
707 SW Gaines St
Portland, OR 97239-2901
Phone (503) 494-7863
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022448 | Medicaid | OR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1972600757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SW GAINES ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392901",
"telephone_number": "503-494-7863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW GAINES ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392901",
"telephone_number": "800-452-3563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUGH",
"first_name": "KERRY",
"middle_name": "LYNN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "4406",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022448",
"state": "OR"
}
],
"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 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.