Individual provider Active NPI

Christina Watanabe

  • Physical Therapist
  • Lincoln City, OR
National Provider Identifier
1033791330
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3007 NE West Devils Lake Rd
Lincoln City, OR 97367-5131
Phone
(541) 994-6252
NPI assigned
Apr 26, 2021
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

3007 NE West Devils Lake Rd
Lincoln City, OR 97367-5131

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 682-8840

Other names 1

  • Christina Ballew Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3005ORMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince May 24, 2021 Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince May 24, 2021 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist Current Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

3007 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-6252

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1033791330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-682-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 NE WEST DEVILS LAKE RD",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973675131",
            "telephone_number": "541-994-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "BALLEW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.