NPIMap

Organization Active NPI

Oregon Neurosport Physical Therapy

  • Physical Therapist
  • Junction City, OR
National Provider Identifier
1073667218
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OREGON NEUROSPORT PHYSICAL THERAPY
Practice address
680 Ivy St
Junction City, OR 97448-1636
Phone
(541) 998-9988
Fax
(541) 998-9987
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

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

Authorized official

Name
Mr. Michael Howard Baum, BS, CFMTNPI 1144399213
Title
Physical Therapist
Phone
(541) 998-9988

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Neurology Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251N0400X
Sports Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251S0007X

Addresses

Primary practice location

680 Ivy St
Junction City, OR 97448-1636

Mailing address

PO Box 275
Junction City, OR 97448-0275
Phone (541) 998-9988

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000043 OR Part B Supplier - Clinic/Group Practice 6305827619 Receives reassigned benefits from 3 practitioners
Practice locations: Junction City, OR

National Provider Directory

National Provider Directory

Locations

680 Ivy St
Junction City, OR 97448
Phone (541) 998-9988

321 Holly St
Junction City, OR 97448
Phone (541) 998-9988

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1073667218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 275",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974480275",
            "telephone_number": "541-998-9988",
            "fax_number": "541-998-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 IVY ST",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974481636",
            "telephone_number": "541-998-9988",
            "fax_number": "541-998-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON NEUROSPORT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "BAUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "541-998-9988",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS, CFMT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.