NPIMap

Organization Active NPI

Gateway Parkrose Sports Care PT LLC

  • Physical Therapy Clinic/Center
  • Portland, OR
National Provider Identifier
1982748141
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1660 Issued in OR
Legal business name
GATEWAY PARKROSE SPORTS CARE PT LLC
Practice address
10748 NE Halsey St
Portland, OR 97220
Phone
(502) 257-9881
Fax
(503) 257-8964
NPI assigned
Feb 19, 2007
Last updated
Sep 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Authorized official

Name
Joseph J Fricke, PTNPI 1851350870
Title
Owner
Phone
(503) 257-9881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1660 OR Primary

Addresses

Primary practice location

10748 NE Halsey St
Portland, OR 97220

Mailing address

10748 NE Halsey St
Portland, OR 97220-3961
Phone (502) 257-9881

Other practice location 1

11300 NE Halsey St
Suite 102
Portland, OR 97220-2096
Phone (502) 257-9881

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1982748141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10748 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203961",
            "telephone_number": "502-257-9881",
            "fax_number": "503-257-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10748 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "502-257-9881",
            "fax_number": "503-257-8964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11300 NE Halsey St",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972202096",
            "country_code": "US",
            "telephone_number": "502-257-9881",
            "fax_number": "503-257-8964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GATEWAY PARKROSE SPORTS CARE PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2018-09-07",
        "status": "A",
        "authorized_official_last_name": "FRICKE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-257-9881",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "1660",
            "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 Sep 7, 2018; 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.