Individual provider Active NPI

Jarrod Lummis, PT

  • Orthopedic Physical Therapist
  • Salem, OR
National Provider Identifier
1194098517
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT60112
Practice address
1600 State St
Salem, OR 97301
Phone
(503) 540-6300
Fax
(503) 540-6404
NPI assigned
Feb 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2012004495 MO
Orthopedic Physical Therapist 2251X0800X PT60112 Primary

Addresses

Primary practice location

1600 State St
Salem, OR 97301

Mailing address

1600 State St
Salem, OR 97301-4257
Phone (503) 540-6300

Other practice location 1

188A Medical Dr
Hannibal, MO 63401-6877
Phone (573) 406-0576

Other practice location 2

188A Medical Dr
Hannibal, MO 63401-6877
Phone (573) 406-0576

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

State licenses

LicenseStateTypeSpecialty
2012004495MOMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1194098517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "188A Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016877",
            "country_code": "US",
            "telephone_number": "573-406-0576",
            "fax_number": "573-406-1371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "188A Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016877",
            "country_code": "US",
            "telephone_number": "573-406-0576",
            "fax_number": "573-406-1371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUMMIS",
        "first_name": "JARROD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2012004495",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": "PT60112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.