Individual provider Active NPI

Richard Walter Roskopf, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1982724795
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
9601 Issued in OR
Practice address
11507 SW Shilo Lane
Ste E
Portland, OR 97225
Phone
(503) 939-2524
Fax
(503) 520-0514
NPI assigned
Mar 29, 2007
Last updated
Aug 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 9601 OR Primary

Addresses

Primary practice location

11507 SW Shilo Lane
Ste E
Portland, OR 97225

Mailing address

11507 SW Shilo Lane
Ste E
Portland, OR 97225
Phone (503) 939-2524

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

LicenseStateTypeSpecialty
9601ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Injury Care and Movement Therapy LLC Massage Therapist Past Accepting new patients
Laura a Swingen DC PC PastSince Aug 1, 2008 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1982724795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11507 SW SHILO LANE",
            "address_2": "STE E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-939-2524",
            "fax_number": "503-520-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11507 SW SHILO LANE",
            "address_2": "STE E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-939-2524",
            "fax_number": "503-520-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSKOPF",
        "first_name": "RICHARD",
        "middle_name": "WALTER",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "9601",
            "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 Aug 26, 2011; 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.