Individual provider Active NPI

Joseph D Nance, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1124089537
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60503 Issued in OR
Practice address
1303 NE Cushing Drive
Suite 150
Bend, OR 97701-3891
Phone
(541) 382-7875
Fax
(541) 382-2181
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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 60503 OR Primary

Addresses

Primary practice location

1303 NE Cushing Drive
Suite 150
Bend, OR 97701-3891

Mailing address

805 SW Industrial Way
Suite 3
Bend, OR 97702-1093
Phone (541) 585-2529

Other identifiers 1

IdentifierTypeStateIssuer
500669801MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060420000215 WA Practitioner - Physical Therapist in Private Practice 2264441187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Washington Physical Therapy LLCGroup PAC ID 3476679812, 54 clinicians

Practice addresses (Care Compare)

209 Kirkland Ave
Kirkland, WA 98033-6503
Phone (425) 629-3502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60503ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Washington Physical Therapy LLC Physical Therapist CurrentSince May 1, 2019 Accepting new patients
Olympic Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Issaquah Physical Therapy, Inc PastSince Jan 6, 2009 Accepting new patients
Elevate Physical Rehabilitation Group PLLC Physical Therapist PastSince Jun 1, 2018 Accepting new patients
Sammamish Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

6704 NE 181st St
Ste 101
Kenmore, WA 98028
Phone (425) 246-9799

209 Kirkland Ave
Kirkland, WA 98033
Phone (425) 629-3502

Organizations & group practices 5

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1124089537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY",
            "address_2": "SUITE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021093",
            "telephone_number": "541-585-2529",
            "fax_number": "541-585-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 NE CUSHING DRIVE",
            "address_2": "SUITE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013891",
            "telephone_number": "541-382-7875",
            "fax_number": "541-382-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANCE",
        "first_name": "JOSEPH",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500669801",
            "state": "OR"
        }
    ],
    "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 17, 2016; 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.