Restora Physical Therapy Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RESTORA PHYSICAL THERAPY INC

Practice address

124 NE Broadway St
Myrtle Creek, OR 97457-9039

Phone

(541) 860-8556

NPI assigned

Aug 28, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Janet Walden, PTNPI 1710236427

Title

President & Ceo

Phone

(541) 860-8556

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

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

• Janet Nelson Walden, P.T.

  • Physical Therapist
  • Columbia, MO
  • NPI 1710236427

  OR, Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1093694598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "974570001",
            "telephone_number": "541-860-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NE BROADWAY ST",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "974579039",
            "telephone_number": "541-860-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORA PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "WALDEN",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "541-860-8556",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Ily Osborne, MS CCC-SLP
• Mark C Phillips, MD
• Jordan Lane Pringle
• Thomas Pugel, LMFT
• Kain Taylor Queck, DC
• JD Tucker Rohm, D.C.
• Lonnie D Sanders, RPH
• Emily Savage, PHARM.D (RPH)
• Jaime Francisco Serranzana, MD
• Ralph Michael Shirtcliff, D.M.D.

• All providers in Myrtle Creek, OR
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.