Dan Richard Ibarra, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3599 Issued in OR

Practice address

2395 NW Stewart Pkwy
Roseburg, OR 97470-5653

Phone

(541) 957-5825

Fax

(541) 957-5801

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northwest Physical Therapy, Inc

  • Physical Therapist
  • Roseburg, OR
  • NPI 1144420910
  Medicare reassignment NPD

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073680328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974705653",
            "telephone_number": "541-957-5825",
            "fax_number": "541-957-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974705653",
            "telephone_number": "541-957-5825",
            "fax_number": "541-957-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBARRA",
        "first_name": "DAN RICHARD",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahaylie Huntley
• Alexis Rachelle Hurd, MSW
• Leslie Hurley
• Kevin Scott Huskey
• Kacie Huson, LCSW
• Icco LLC
• Icco LLC
• Icco, LLC
• Icco, LLC
• Arielle Illia

• Physical Therapist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.