Individual provider Active NPI

Colbie J Jorgensen, PT

  • Physical Therapist
  • Tigard, OR
National Provider Identifier
1043412000
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60953 Issued in OR
Practice address
11900 SW Greenburg Rd
Tigard, OR 97223-6453
Phone
(503) 620-5556
Fax
(503) 624-0118
NPI assigned
Jun 1, 2007
Last updated
Nov 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 76253602401 UT
Physical Therapist 225100000X 60953 OR Primary

Addresses

Primary practice location

11900 SW Greenburg Rd
Tigard, OR 97223-6453

Mailing address

11900 SW Greenburg Rd
Tigard, OR 97223-6453
Phone (503) 620-5556

Other practice location 1

1490 E Foremaster Dr
Suite 110
St George, UT 84790-4488
Phone (435) 652-4455 ext. 104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100611000627 UT Practitioner - Physical Therapist in Private Practice 1456481704 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60953ORMDPhysical Therapist
76253602401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fortify Physical Therapy PLLC Current Accepting new patients
Fortify Physical Therapy PLLC Physical Therapist CurrentSince Feb 19, 2026 Accepting new patients
Revolutions Physical Therapy LLC Current Accepting new patients
Teamworks Therapy LLC PastSince Mar 1, 2010 Accepting new patients
My Other Me PastSince Jun 1, 2015 Accepting new patients

Locations

792 S 3000 E
St George, UT 84790
Phone (208) 431-0211

792 S 3000 E
Ste 104
St George, UT 84790
Phone (208) 431-0211

Organizations & group practices 5

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1043412000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 SW GREENBURG RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236453",
            "telephone_number": "503-620-5556",
            "fax_number": "503-624-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 SW GREENBURG RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236453",
            "telephone_number": "503-620-5556",
            "fax_number": "503-624-0118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 E Foremaster Dr",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847904488",
            "country_code": "US",
            "telephone_number": "435-652-4455 x104",
            "fax_number": "435-652-4472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "COLBIE",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "76253602401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.