NPIMap

Organization Active NPI

Mobile Physical Therapy, LLC

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1083846794
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOBILE PHYSICAL THERAPY, LLC
Practice address
1031 NW Kingston Ave
Bend, OR 97703-2334
Phone
(541) 617-0776
NPI assigned
Aug 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Authorized official

Name
Kathleen Bradley, PTNPI 1851373989
Title
Owner
Phone
(541) 617-0776

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 1

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

Addresses

Primary practice location

1031 NW Kingston Ave
Bend, OR 97703-2334

Mailing address

PO Box 2190
Bend, OR 97709-2190
Phone (541) 390-7438

National Provider Directory

National Provider Directory

Locations

1045 NW Bond St
Ste 203
Bend, OR 97703
Phone (541) 390-7438

Practitioners & affiliated clinicians

Practitioners 2

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": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1083846794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2190",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977092190",
            "telephone_number": "541-390-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 NW KINGSTON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032334",
            "telephone_number": "541-617-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-617-0776",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.