NPIMap

Organization Active NPI

Jackson County Physical Therapy LLP

  • Physical Therapist
  • Medford, OR
National Provider Identifier
1013112903
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 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
Last updated
Jun 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Cameron McCandless
Title
Practice Administrator
Phone
(541) 776-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

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 names 1

  • Jackson County Physical Therapy Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Locations

370 E Hersey St
Ste 1
Ashland, OR 97520
Phone (541) 482-6360

36 Hawthorne St
Medford, OR 97504
Phone (541) 776-2333

709 N Phoenix Rd
Medford, OR 97504
Phone (541) 324-8006

242 N Phoenix Rd
Phoenix, OR 97535
Phone (541) 512-0757

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1013112903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HAWTHORNE ST.",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047114",
            "telephone_number": "541-776-2333",
            "fax_number": "541-776-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 HAWTHORNE ST.",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047114",
            "telephone_number": "541-776-2333",
            "fax_number": "541-776-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY PHYSICAL THERAPY LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "MCCANDLESS",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "541-776-2333"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson County Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.