Jackson County Physical Therapy LLP
Organization Active NPI Physical Therapist · Medford, OR
NPI 1013112903 · NPPES record last updated Jun 8, 2015
Key facts
- NPI
- 1013112903
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- JACKSON COUNTY PHYSICAL THERAPY LLP
- Practice address
- 36 Hawthorne St.
Medford, OR 97504-7114 - Phone
- (541) 776-2333
- Fax
- (541) 776-2495
- NPI assigned
- Jun 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Cameron McCandless
- Title
- Practice Administrator
- Phone
- (541) 776-2333
Practitioners 40
-
Sydney Ann Beck, PT, DPT
-
Meagan Blank, DPT
-
Kathy Bowlin, PT
-
Scott P Byrd, PT
-
Lauri Schaefer, DPT
-
Jolene L Faught, PT
-
Sharin Lane, DPT
-
Daniel Brasch, DPT
-
Matthew Thomas Jurek, DPT, CSCS
-
Lisa Rose Ralston, P.T.
-
Amber Katrina Cross, DPT
-
Jack Gillingham, PT, DPT
-
Shelby Morrison, DPT
-
Isaac David Swafford Durrington, PT, DPT
-
Brandhen Snyder, M.P.T.
-
Ann Mariko Bouse, PT
-
Scott L Brown, P.T.
-
Lance Cooper, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040525001770 | OR | Part B Supplier - Clinic/Group Practice | 4284615311 |
Receives reassigned benefits from 19 practitioners 1 other NPI on this enrollment Practice locations: Medford, OR; Talent, OR; Phoenix, OR; Eagle Point, OR |
National Provider Directory
Locations
370 E Hersey St
Ste 1
Ashland, OR 97520
Phone (541) 482-6360
709 N Phoenix Rd
Medford, OR 97504
Phone (541) 324-8006
36 Hawthorne St
Medford, OR 97504
Phone (541) 776-2333
242 N Phoenix Rd
Phoenix, OR 97535
Phone (541) 512-0757
288 S Pacific Hwy
Talent, OR 97540
Phone (541) 482-6360
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
36 Hawthorne St.
Medford, OR 97504-7114
Mailing address
36 Hawthorne St.
Medford, OR 97504-7114
Phone (541) 776-2333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CK6710 | Other | OR | RAILROAD MC |
| 131362 | Medicaid | OR |
Other names
- Jackson County Physical Therapy
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.