Individual provider Active NPI

Gunn Jeanette Menegus, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1144453846
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4450 Issued in OR
Practice address
1160 SW Simpson Ave
Ste 200
Bend, OR 97702-3542
Phone
(541) 322-9045
Fax
(541) 322-9044
NPI assigned
Aug 27, 2009
Last updated
Jun 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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 4450 OR Primary

Addresses

Primary practice location

1160 SW Simpson Ave
Ste 200
Bend, OR 97702-3542

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
500654248MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101209001162 OR Practitioner - Physical Therapist in Private Practice 1850588377 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4450ORMDNaprapath

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Peterson LCSW LLC CurrentSince Aug 1, 2024 Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Jan 16, 2020 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince Jan 16, 2020 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
Hands on Physical Therapy, PC CurrentSince Aug 1, 2024 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

4933 Old Greenwood Rd
Fort Smith, AR 72903

147 SW Shevlin Hixon Dr
#1
Bend, OR 97702
Phone (541) 312-2252

147 SW Shevlin Hixon Dr
Ste 104
Bend, OR 97702
Phone (541) 312-2252

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

4254 Weathers St NE
Salem, OR 97301
Phone (503) 585-4602

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1144453846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY",
            "address_2": "STE 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": "1160 SW SIMPSON AVE",
            "address_2": "STE 200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023542",
            "telephone_number": "541-322-9045",
            "fax_number": "541-322-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENEGUS",
        "first_name": "GUNN",
        "middle_name": "JEANETTE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500654248",
            "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 Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.