Individual provider Active NPI

Mary Gorman, PT/LMT

  • Physical Therapist
  • Ashland, OR
National Provider Identifier
1073606828
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3975 Issued in OR
Practice address
2205 Ashland St Ste 204
Ashland, OR 97520-1971
Phone
(541) 482-0242
Fax
(541) 482-0231
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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 3975 OR Primary

Addresses

Primary practice location

2205 Ashland St Ste 204
Ashland, OR 97520-1971

Mailing address

309 S Pacific Hwy
Talent, OR 97540-6650
Phone (541) 535-7019

Other identifiers 2

IdentifierTypeStateIssuer
084229000OtherORBLUECROSS BLUESHIELD
299328MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041223000222 OR Practitioner - Physical Therapist in Private Practice 1951369875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kleiman and Stamper Physical Therapy LLCGroup PAC ID 8123175858, 3 clinicians

Practice addresses (Care Compare)

2205 Ashland St
Suite 204
Ashland, OR 97520-1971
Phone (541) 482-0242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3975ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kleiman & Stamper Physical Therapy LLC Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
Dynamic Health Partners, PC PastSince Jan 1, 2015 Accepting new patients

Locations

2205 Ashland St
Ste 204
Ashland, OR 97520
Phone (541) 482-0242

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1073606828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S PACIFIC HWY",
            "city": "TALENT",
            "state": "OR",
            "postal_code": "975406650",
            "telephone_number": "541-535-7019",
            "fax_number": "541-512-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 ASHLAND ST STE 204",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201971",
            "telephone_number": "541-482-0242",
            "fax_number": "541-482-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "MARY",
        "credential": "PT/LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "084229000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299328",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.