Bend Physical Therapy Associates

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BEND PHYSICAL THERAPY ASSOCIATES

Doing business as

TAI Central Oregon Athletic Club of Bend

Practice address

61615 Athletic Club Dr
Bend, OR 97702-3124

Phone

(541) 382-7890

Fax

(541) 382-7498

NPI assigned

Dec 19, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Todd Robert Gifford, PT

Title

Coo

Phone

(800) 219-8835

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• TAI Central Oregon Athletic Club of Bend Doing business as

Locations

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1144206517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11481 SW HALL BLVD",
            "address_2": "STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238403",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61615 ATHLETIC CLUB DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023124",
            "telephone_number": "541-382-7890",
            "fax_number": "541-382-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEND PHYSICAL THERAPY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "GIFFORD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-219-8835",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "197670363",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAI Central Oregon Athletic Club of Bend",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.