Individual provider Active NPI

Trenton Jacob Tipton, PT, DPT

  • Physical Therapist
  • Albany, OR
National Provider Identifier
1124861380
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021167 Issued in OH
Practice address
1046 6TH Ave SW
Albany, OR 97321-1916
Phone
(541) 812-4000
NPI assigned
Jun 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP032012T OR
Physical Therapist 225100000X PT021167 OH Primary

Addresses

Primary practice location

1046 6TH Ave SW
Albany, OR 97321-1916

Mailing address

43186 Jerrill Dr
Saint Clairsville, OH 43950-9647
Phone (740) 827-7849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241223000311 NC Practitioner - Physical Therapist in Private Practice 6507393089 Reassigns benefits to 1 organization
I20251117002926 ID Practitioner - Physical Therapist in Private Practice 6507393089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Ohio Medical University, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maleki Physical Therapy ServicesGroup PAC ID 5092176545, 7 clinicians

Practice addresses (Care Compare)

671 E Riverpark LN
Suite 150
Boise, ID 83706-6559
Phone (208) 912-6981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT021167OHMDPhysical Therapist
CP032012TORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards and Associates Physical Therapy Physical Therapist CurrentSince Nov 12, 2024 Accepting new patients
Carolina Rehabilitation Inc Physical Therapist CurrentSince Nov 12, 2024 Accepting new patients
Maleki Physical Therapy Services Physical Therapist CurrentSince Nov 4, 2025 Accepting new patients

Locations

671 E Riverpark Ln
Ste 150
Boise, ID 83706
Phone (208) 912-6981

1940 S Bonito Way
Ste 170
Meridian, ID 83642
Phone (208) 912-6615

159 Crossover Rd
Beulaville, NC 28518
Phone (910) 298-6455

Organizations & group practices 3

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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1124861380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43186 JERRILL DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439509647",
            "telephone_number": "740-827-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 6TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211916",
            "telephone_number": "541-812-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "TRENTON",
        "middle_name": "JACOB",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "CP032012T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.