Individual provider Active NPI

Neena Marie Kirkwood, D.P.T.

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1992896740
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5194 Issued in OR
Practice address
10915 SE Stark St
Portland, OR 97216-3348
Phone
(503) 261-1120
Fax
(503) 261-8936
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5194 OR Primary

Addresses

Primary practice location

10915 SE Stark St
Portland, OR 97216-3348

Mailing address

10915 SE Stark St
Portland, OR 97216-3348
Phone (503) 261-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110000761 WA Practitioner - Physical Therapist in Private Practice 0749374445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapydia of Washington PCGroup PAC ID 9931633492, 22 clinicians

Practice addresses (Care Compare)

1125 SE 163Rd PL
Suite 102
Vancouver, WA 98683-4468
Phone (360) 768-4340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5194ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapydia of Washington PC Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Pivot Health Acupuncture CurrentSince Jan 28, 2024 Accepting new patients

Locations

8810 SE Sunnybrook Blvd
Ste 100
Clackamas, OR 97015
Phone (503) 261-1120

1125 SE 163rd Pl
Ste 102
Vancouver, WA 98683
Phone (360) 658-4340

7604 NE 5th Ave
Ste 109
Vancouver, WA 98665
Phone (360) 314-4380

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1992896740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163348",
            "telephone_number": "503-261-1120",
            "fax_number": "503-261-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163348",
            "telephone_number": "503-261-1120",
            "fax_number": "503-261-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKWOOD",
        "first_name": "NEENA",
        "middle_name": "MARIE",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5194",
            "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 Jun 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.