NPIMap

Organization Active NPI

Columbia Gorge Physical Therapy Inc

  • Physical Therapist
  • Hood River, OR
National Provider Identifier
1073504809
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
COLUMBIA GORGE PHYSICAL THERAPY INC
Practice address
2002 12TH St
Hood River, OR 97031-9543
Phone
(541) 386-1211
Fax
(541) 386-7211
NPI assigned
Nov 1, 2005
Last updated
Sep 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Authorized official

Name
Bettina M Bardin-Sorensen, PTNPI 1407847742
Title
Owner
Phone
(541) 386-1211

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 Therapist 225100000X NU Primary

Addresses

Primary practice location

2002 12TH St
Hood River, OR 97031-9543

Mailing address

2002 12TH St
Hood River, OR 97031-9543
Phone (541) 386-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318001047 OR Part B Supplier - Clinic/Group Practice 6709776198 Receives reassigned benefits from 12 practitioners
Practice locations: Hood River, OR

National Provider Directory

National Provider Directory

Locations

2002 12th St
Hood River, OR 97031
Phone (541) 386-1211

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505174400000",
    "number": "1073504809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 12TH ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970319543",
            "telephone_number": "541-386-1211",
            "fax_number": "541-386-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 12TH ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970319543",
            "telephone_number": "541-386-1211",
            "fax_number": "541-386-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA GORGE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2017-09-12",
        "status": "A",
        "authorized_official_last_name": "BARDIN-SORENSEN",
        "authorized_official_first_name": "BETTINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-386-1211",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.