Individual provider Active NPI

Kathy Meldrum, P.T.

  • Physical Therapist
  • Springfield, OR
National Provider Identifier
1124242086
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4956 Issued in OR
Practice address
145 S 52ND PL
Springfield, OR 97478-6210
Phone
(541) 988-3337
Fax
(541) 988-3289
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4956 OR Primary

Addresses

Primary practice location

145 S 52ND PL
Springfield, OR 97478-6210

Mailing address

145 S 52ND PL
Springfield, OR 97478-6210
Phone (541) 988-3337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908001037 OR Practitioner - Physical Therapist in Private Practice 4284666397 Reassigns benefits to 3 organizations

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
Willamette Community Health SolutionsGroup PAC ID 5496667578, shared by 3 NPIs, 30 clinicians

Practice addresses (Care Compare)

89 Centennial Loop
Suite a
Eugene, OR 97401-7917
Phone (541) 342-1632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4956ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Nov 1, 2015 Accepting new patients
Icco LLC CurrentSince Nov 1, 2015 Accepting new patients
Willamette Community Health Solutions Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
Willamette Community Health Solutions CurrentSince Feb 1, 2022 Accepting new patients
McKenzie Crossing Orthopedic Physical Therapy Inc Physical Therapist PastSince Jan 1, 2001 Accepting new patients
Willamette Community Health Solutions Past Accepting new patients

Locations

2650 Suzanne Way
Ste 200
Eugene, OR 97408
Phone (541) 228-3000

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

1800 Coburg Rd
Eugene, OR 97401
Phone (541) 342-1632

89 Centennial Loop
Ste A
Eugene, OR 97401
Phone (541) 228-3000

Organizations & group practices 6

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124242086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S 52ND PL",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786210",
            "telephone_number": "541-988-3337",
            "fax_number": "541-988-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S 52ND PL",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786210",
            "telephone_number": "541-988-3337",
            "fax_number": "541-988-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELDRUM",
        "first_name": "KATHY",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.