MIGHTY OAKS CHILDREN'S THERAPY CENTER (NPI# 1902935414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902935414 |
Entity Type | Organization |
Organization Name | MIGHTY OAKS CHILDREN'S THERAPY CENTER |
Other Organization Name | MIGHTY OAKS DEVELOPMENTAL CENTER |
Practice Address |
3615 Spicer Dr Se Albany OR 97322-7043 |
Practice Telephone | 5419677551 |
Practice Fax Number | 5419675095 |
Mailing Telephone | 5419677551 |
Mailing Fax Number | 5419675095 |
Enumeration Date | 2007-03-02 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MRS. TAMI M WALTERS (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 5419677551 |
Authorized Official Credential | M.O.T. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
X | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
X | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | BLUE CROSS BLUE SHIELD | 7008454 | 01 |
Other Name | Type Code |
---|---|
Mighty Oaks Developmental Center | Former Legal Business Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | MIGHTY OAKS CHILDREN'S THERAPY CENTER | 3615 Spicer Rd Se, Albany, OR 97322 |
Street Address |
3615 SPICER DR SE |
City | ALBANY |
State | OR |
Zip Code | 97322-7043 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619928645 | Tami Marie Walters | Occupational Therapist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2006-05-15 |
1609484815 | Leila Laurila | Speech-Language Pathologist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2020-07-14 |
1841818358 | Charlotte Wright | Speech-Language Pathologist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2020-07-10 |
1386262905 | Billie Nadine Davis | Speech-Language Pathologist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2020-07-09 |
1124653738 | Susan May Stewart | Speech-Language Pathologist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2020-03-04 |
1972145597 | Analisa Vanoostrum | Physical Therapist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2019-10-15 |
1568004497 | Diana Lynne Scarborough | Occupational Therapist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2019-10-11 |
1912564147 | Hailey Amanda Eustice | Speech-Language Pathologist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2019-05-22 |
1336654482 | Kelly Elizabeth Calton | Occupational Therapist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2017-12-12 |
1033463716 | Amber Fleming | Physical Therapist | 3615 Spicer Dr Se, Albany, OR 97322-7043 | 2012-11-02 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083109748 | Benjamin Voth | Counselor | 1858 Grand Prairie Rd Se, Albany, OR 97322 | 2018-06-26 |
1033534748 | Willamette Orthotics & Prosthetics, LLC | Durable Medical Equipment & Medical Supplies | 1630 9th Ave Se, Albany, OR 97322 | 2014-03-04 |
1699035998 | Morgan William Brown | Behavioral Analyst | 1885 21 St Ave Se Apt 44, Albany, OR 97322 | 2012-05-21 |
1780986059 | Gene Vang | Pharmacist | 1330 Goldfish Farm Rd Se, Albany, OR 97322 | 2010-11-18 |
1427362912 | Kate Fredrickson | Speech-Language Pathologist | 5353 Columbus St. Se, Albany, OR 97322 | 2010-07-27 |
1689906455 | Sandy Janiszewski | Registered Nurse | 1970 4th Ave. Se, Ste 120, Albany, OR 97322 | 2010-02-04 |
1841527066 | Karina Leonore Towers | Speech-Language Pathologist | 5353 Columbus Street Se, Albany, OR 97322 | 2009-11-09 |
1548497951 | T.c.s. Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3012 Se Oakwood Avenue, Albany, OR 97322 | 2009-06-12 |
1790932952 | Ramel C Romero | Physical Therapist | 5353 Colombus St Se, Albany, OR 97322 | 2008-08-19 |
1023275492 | Michael James | Hearing Instrument Specialist | 1610 9th Av. Se, Albany, OR 97322 | 2008-05-21 |
Find all providers in zip 97322 |
Taxonomy Code | 2251P0200X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669675047 | Lisa J. Herzog | Physical Therapist | 22 Bosher Dr, Albany, NY 12205-1702 | 2007-06-06 |
1447629050 | Nancy Hellman | Physical Therapist | 26 Computer Dr E, Albany, NY 12205-1112 | 2015-09-24 |
1730589847 | Athena Batsios | Physical Therapist | 1 Rapp Rd, Albany, NY 12203-4491 | 2014-08-26 |
1346487535 | Antonia Margaret Aliberti | Physical Therapist | 1 Rapp Rd, Albany, NY 12203-4491 | 2009-01-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275156101 | Pace Pediatric Therapy, Inc. | Physical Therapist | 3701 Se Milwaukie Ave Ste G, Portland, OR 97202-3835 | 2020-05-27 |
1427691740 | First Steps Physical Therapy, LLC | Physical Therapist | 911 Main St Ste 100, Oregon City, OR 97045-1853 | 2019-10-18 |
1467804773 | Rebecca D. Sander | Physical Therapist | 17113 Sw Green Heron Dr, Sherwood, OR 97140-8972 | 2016-07-11 |
1841426434 | Rebecca Additon Veltri | Physical Therapist | 32513 Joseph Ln, Philomath, OR 97370-9130 | 2009-06-09 |
1396943932 | Kathleen Marie Hogan | Physical Therapist | 132 Formac Ave, Eugene, OR 97404-2606 | 2007-07-05 |
1306050646 | Pediatric Therapyworks | Physical Therapist | 30714 Se Dodge Park Blvd, Gresham, OR 97080-8961 | 2007-05-09 |
1790814200 | Susan Nicklin | Physical Therapist | 945 S Riverside Ave, Medford, OR 97501-7841 | 2007-03-02 |
1396898441 | Johanna Lydia Buck | Physical Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2007-01-20 |
1912068941 | Sandra Lee Saavedra | Physical Therapist | 1763 Moss St, Eugene, OR 97403-1946 | 2006-12-13 |
1164598462 | Joy Danielle Shank | Physical Therapist | 7203 Se Raymond St, Portland, OR 97206-4323 | 2006-11-28 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.