Ptconnectllc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PTCONNECTLLC

Doing business as

PTCONNECT Physical Therapy

Practice address

7468 Everwood St NE
Keizer, OR 97303-7858

Phone

(503) 451-5058

NPI assigned

Apr 20, 2021

Last updated

Mar 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fahrueldin Dean Ebed, DPT

Title

Ceo

Phone

(503) 473-6553

Specialties & licenses 1

Addresses

Other names 1

• PTCONNECT Physical Therapy Doing business as

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1023699964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7468 EVERWOOD ST NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973037858",
            "telephone_number": "503-451-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7468 EVERWOOD ST NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973037858",
            "telephone_number": "503-451-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PTCONNECTLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "EBED",
        "authorized_official_first_name": "FAHRUELDIN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-473-6553",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PTCONNECT Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victor Valentin Prati, P.T.
• Scott Michael Prentice, MPH, QMHA
• Margi D Pringle, LMT
• Professional Interpreters
• Rebecca Susann Proulx, RN
• Alisha Putnam
• Sabrina Pyl
• Diesha Raish, LMT
• Joseph Rambeck
• Taren Rambeck

• Physical Therapist in Keizer, OR
• Providers in Keizer, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.