Individual provider Active NPI

Kevin O'Donnell, DPT

  • Physical Therapist
  • Salem, OR
National Provider Identifier
1003412446
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP039794T Issued in CO
Practice address
4555 Liberty Rd S Ste 400
Salem, OR 97302-5091
Phone
(503) 485-1666
NPI assigned
Dec 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP058712T OR
Physical Therapist 225100000X PT020170 OH
Physical Therapist 225100000X CP039794T CO Primary

Addresses

Primary practice location

4555 Liberty Rd S Ste 400
Salem, OR 97302-5091

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

375 E Horsetooth Rd Bldg 4
Fort Collins, CO 80525-3155
Phone (303) 940-0757

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231002001814 WA Practitioner - Physical Therapist in Private Practice 7315391836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of Oregon LLCGroup PAC ID 0143510602, 124 clinicians

Practice addresses (Care Compare)

4555 Liberty Rd S
Suite 400
Salem, OR 97302-5091
Phone (503) 485-1666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP039794TCOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Highline Physical Therapy Group Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients
Highline Physical Therapy Group Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Past Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist PastSince Jun 17, 2026 Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist PastSince Jun 17, 2026 Accepting new patients
MVP Physical Therapy, LLC Physical Therapist PastSince Jun 5, 2018 Accepting new patients

Locations

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

13050 Military Rd S
Tukwila, WA 98168
Phone (206) 248-3080

Organizations & group practices 7

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1003412446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 LIBERTY RD S STE 400",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025091",
            "telephone_number": "503-485-1666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 E Horsetooth Rd Bldg 4",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805253155",
            "country_code": "US",
            "telephone_number": "303-940-0757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "KEVIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "CP058712T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT020170",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP039794T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.