NPIMap

Organization Active NPI

Eastern Oregon Physical Therapy

  • Physical Therapist
  • Pendleton, OR
National Provider Identifier
1013933985
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3672 Issued in OR
Legal business name
EASTERN OREGON PHYSICAL THERAPY
Practice address
1100 Southgate
Suite 1
Pendleton, OR 97801-3974
Phone
(541) 276-4011
Fax
(541) 278-2327
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Richard Wortley, PTNPI 1689667859
Title
Owner
Phone
(541) 276-4011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 3672 OR Primary

Addresses

Primary practice location

1100 Southgate
Suite 1
Pendleton, OR 97801-3974

Mailing address

PO Box 307
Bountiful, UT 84011-0307
Phone (888) 700-6907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414001121 OR Part B Supplier - Clinic/Group Practice 8729072350 Receives reassigned benefits from 6 practitioners
Practice locations: Pendleton, OR

National Provider Directory

National Provider Directory

Locations

1100 Southgate
Ste 15
Pendleton, OR 97801
Phone (541) 276-4011

1100 Southgate
Ste 1
Pendleton, OR 97801
Phone (541) 276-4011

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1013933985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "888-700-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SOUTHGATE",
            "address_2": "SUITE 1",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013974",
            "telephone_number": "541-276-4011",
            "fax_number": "541-278-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN OREGON PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "WORTLEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-276-4011",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.