Bridge Street Physical Therapy LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

0495 Issued in OR

Legal business name

BRIDGE STREET PHYSICAL THERAPY LLC

Practice address

215 S Bridge St
Sheridan, OR 97378-1807

Phone

(503) 843-7617

Fax

(503) 843-7618

NPI assigned

Mar 20, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Robert L Thornburg, PT

Title

Physical Therapist/Manager

Phone

(503) 843-7617

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1124393392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S BRIDGE ST",
            "city": "SHERIDAN",
            "state": "OR",
            "postal_code": "973781807",
            "telephone_number": "503-843-7617",
            "fax_number": "503-843-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S BRIDGE ST",
            "city": "SHERIDAN",
            "state": "OR",
            "postal_code": "973781807",
            "telephone_number": "503-843-7617",
            "fax_number": "503-843-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE STREET PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "THORNBURG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/MANAGER",
        "authorized_official_telephone_number": "503-843-7617",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "0495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel D Barney, CADC-R, CRM
• Sabina Kayla Beusch
• Sue M. Brandt, COTA
• Cody Charron
• David Collins, MD
• Randy Eugene Crowe, L.AC.
• Deer Meadow LLC
• Federal Correctional Institution Sheridan

• Clinic/Center in Sheridan, OR
• Providers in Sheridan, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.