Individual provider Active NPI

Jeremy Solomon, DPT

  • Physical Therapist
  • Corvallis, OR
National Provider Identifier
1073886255
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
06346 Issued in OR
Practice address
815 NW 9TH St
Suite180
Corvallis, OR 97330-6173
Phone
(541) 768-5157
NPI assigned
Feb 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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 06346 OR Primary

Addresses

Primary practice location

815 NW 9TH St
Suite180
Corvallis, OR 97330-6173

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsolomon5141@samhealth.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170224000767 OR Practitioner - Physical Therapist in Private Practice 8921382649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Physical Therapy LLCGroup PAC ID 5193059624, 2 clinicians

Practice addresses (Care Compare)

6735 SW Country Club Dr
Suite 104
Corvallis, OR 97333-1987
Phone (541) 243-5770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06346ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Physical Therapy LLC CurrentSince May 29, 2019 Accepting new patients

Locations

6735 SW Country Club Dr
Ste 104
Corvallis, OR 97333
Phone (541) 243-5770

Interoperability endpoints

  • Direct secure messaging: jsolomon5141@samhealth.direct-ci.com

Organizations & group practices 1

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": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1073886255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 NW 9TH ST",
            "address_2": "SUITE180",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306173",
            "telephone_number": "541-768-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "JEREMY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "06346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsolomon5141@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "815 NW 9th St",
            "address_2": "Suite180",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973306173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.