Individual provider Active NPI

Melissa Rutherford

  • Physical Therapist
  • Beaverton, OR
National Provider Identifier
1104578673
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
16985 NW Cornell Rd Ste 110
Beaverton, OR 97006-5639
Phone
(503) 601-9000
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 Primary

Addresses

Primary practice location

16985 NW Cornell Rd Ste 110
Beaverton, OR 97006-5639

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220303002130 OR Practitioner - Physical Therapist in Private Practice 1759775919 Reassigns benefits to 1 organization
I20240712001844 MA Practitioner - Physical Therapist in Private Practice 1759775919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

50 Gold Star Blvd
Worcester, MA 01606-2812
Phone (508) 856-9510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients
Reliant Medical Group, Inc Physical Therapist CurrentSince Jun 24, 2024 Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients
Reliant Medical Group, Inc CurrentSince Jun 24, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

16985 NW Cornell Rd
Ste 110
Beaverton, OR 97006
Phone (503) 601-9000

440 1st St
Lake Oswego, OR 97034
Phone (503) 744-4826

Organizations & group practices 4

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": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1104578673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16985 NW CORNELL RD STE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065639",
            "telephone_number": "503-601-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.