Active NPI
Helenlisle King, PT
- Physical Therapist
- Bend, OR
National Provider Identifier
1184096372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61385
- Practice address
- 404 NE Penn Ave
Bend, OR 97701 - Phone
- (541) 318-7041
- Fax
- (541) 388-3711
- NPI assigned
- Oct 27, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 61385 | OR | Primary |
Addresses
Primary practice location
404 NE Penn Ave
Bend, OR 97701
Mailing address
2625 SW 30TH St
Redmond, OR 97756-8123
Phone (802) 338-1309
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500696238 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1184096372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 SW 30TH ST",
"city": "REDMOND",
"state": "OR",
"postal_code": "977568123",
"telephone_number": "802-338-1309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 NE PENN AVE",
"city": "BEND",
"state": "OR",
"postal_code": "97701",
"telephone_number": "541-318-7041",
"fax_number": "541-388-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "HELENLISLE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-27",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "61385",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500696238",
"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 Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.