Active NPI
Travis Michael Obermire, DPT
- Physical Therapist
- Corvallis, OR
National Provider Identifier
1013237718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61656
- Practice address
- 845 SW 30TH St
Corvallis, OR 97331-8629 - Phone
- (541) 768-7700
- NPI assigned
- Jun 3, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 2318PT | MT | |
| Physical Therapist | 225100000X | 61656 | OR | Primary |
Addresses
Primary practice location
845 SW 30TH St
Corvallis, OR 97331-8629
Mailing address
PO Box 1189
Corvallis, OR 97339-1189
Other practice location 1
5000 Blue Mountain Rd
Missoula, MT 59804-9213
Phone (406) 251-2323
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tobermire129105@samhealth.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
845 SW 30TH St
Corvallis, OR 97331-8629
Phone (541) 768-7700
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.14 of 100
- Quality
- 85.78
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.31
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61656 | OR | MD | Physical Therapist |
| 2318PT | MT | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Samaritan Hospital Corvallis | Current | Accepting new patients | |
| Good Samaritan Hospital Corvallis | Current | Accepting new patients |
Locations
3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261
845 SW 30th St
Corvallis, OR 97331
Phone (541) 768-7700
Networks
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
Interoperability endpoints
- tobermire129105@samhealth.direct-ci.com
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.
-
- General Acute Care Hospital
- Corvallis, OR
- NPI 1962453134
-
- Gynecologic Oncology Physician
- Corvallis, OR
- NPI 1710787916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612396800000",
"number": "1013237718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1189",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 SW 30TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973318629",
"telephone_number": "541-768-7700"
}
],
"practiceLocations": [
{
"address_1": "5000 Blue Mountain Rd",
"address_purpose": "LOCATION",
"city": "Missoula",
"state": "MT",
"postal_code": "598049213",
"country_code": "US",
"telephone_number": "406-251-2323",
"fax_number": "406-251-3332",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OBERMIRE",
"first_name": "TRAVIS",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-03",
"last_updated": "2021-02-04",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MT",
"license": "2318PT",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "61656",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tobermire129105@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "845 SW 30th St",
"city": "Corvallis",
"state": "OR",
"country_code": "US",
"postal_code": "973318629",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.