Individual provider Active NPI

Jodi Kathryn Flanagan, M.P.T.

  • Physical Therapist
  • Baker City, OR
National Provider Identifier
1184632069
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3687 Issued in OR
Practice address
3950 17TH St Ste B
Baker City, OR 97814-1300
Phone
(541) 523-8888
Fax
(541) 523-8889
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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 3687 OR Primary

Addresses

Primary practice location

3950 17TH St Ste B
Baker City, OR 97814-1300

Mailing address

3950 17TH St Ste B
Baker City, OR 97814-1300
Phone (541) 523-8888

Other identifiers 3

IdentifierTypeStateIssuer
803931003OtherORBC/BS OF OREGON
P00480330OtherORRAILRAOD MEDICARE
181501MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060210000458 OR Practitioner - Physical Therapist in Private Practice 1557376670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.76 of 100Reported as individual
Quality
83.96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3687ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert J Bachman P T PC Physical Therapist CurrentSince Jan 3, 2006 Accepting new patients

Locations

3950 17th St
Ste B
Baker City, OR 97814
Phone (541) 523-8888

Organizations & group practices 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1184632069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 17TH ST STE B",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141300",
            "telephone_number": "541-523-8888",
            "fax_number": "541-523-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 17TH ST STE B",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141300",
            "telephone_number": "541-523-8888",
            "fax_number": "541-523-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANAGAN",
        "first_name": "JODI",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF OREGON",
            "identifier": "803931003",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD MEDICARE",
            "identifier": "P00480330",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181501",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.