NPIMap

Organization Active NPI

Oregon Coastal Rehab/Dba Newport Physical Therapy

  • Physical Therapist
  • Newport, OR
National Provider Identifier
1073876041
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5955 Issued in OR
Legal business name
OREGON COASTAL REHAB/DBA NEWPORT PHYSICAL THERAPY
Doing business as
Newport Physical Therapy
Practice address
111 SE Douglas St Ste B
Newport, OR 97365-4400
Phone
(541) 265-4252
Fax
(541) 265-8914
NPI assigned
Jun 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
Renee Roberts
Title
Manager
Phone
(541) 265-4252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5955 OR Primary

Addresses

Primary practice location

111 SE Douglas St Ste B
Newport, OR 97365-4400

Mailing address

111 SE Douglas St Ste B
Newport, OR 97365-4400
Phone (541) 265-4252

Other names 1

  • Newport Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120828000395 OR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8123275070 Receives reassigned benefits from 3 practitioners
Practice locations: Newport, OR

National Provider Directory

National Provider Directory
Tax ID family
Newport Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

111 SE Douglas St
Ste B
Newport, OR 97365
Phone (541) 265-4252

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1073876041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SE DOUGLAS ST STE B",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654400",
            "telephone_number": "541-265-4252",
            "fax_number": "541-265-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SE DOUGLAS ST STE B",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654400",
            "telephone_number": "541-265-4252",
            "fax_number": "541-265-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON COASTAL REHAB/DBA NEWPORT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-24",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "541-265-4252"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.