Individual provider Active NPI

Melissa Foley Carlton, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1255420154
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61021 Issued in OR
Practice address
2669 NE Twin Knolls Dr Ste 104
Bend, OR 97701-4895
Phone
(541) 241-0223
Fax
(855) 564-1873
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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 61021 OR Primary

Addresses

Primary practice location

2669 NE Twin Knolls Dr Ste 104
Bend, OR 97701-4895

Mailing address

2669 NE Twin Knolls Dr Ste 104
Bend, OR 97701-4895
Phone (541) 241-0223

Other identifiers 1

IdentifierTypeStateIssuer
500685935MedicaidOR

Other names 1

  • Miss Melissa Anne Foley Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230411001357 OR Practitioner - Physical Therapist in Private Practice 3173592391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2669 NE Twin Knolls Dr
Suite 104
Bend, OR 97701-4895
Phone (541) 241-0223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61021ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oregon Lymphedema and Physical Therapist CurrentSince Dec 16, 2022 Accepting new patients
Sports Injury Physical Therapy, Inc Physical Therapist PastSince May 31, 2005 Accepting new patients
Kevin Wentz Physical Therapy Corporation Physical Therapist Past Accepting new patients

Locations

2669 NE Twin Knolls Dr
Ste 104
Bend, OR 97701
Phone (541) 241-0223

Organizations & group practices 3

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1255420154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 NE TWIN KNOLLS DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014895",
            "telephone_number": "541-241-0223",
            "fax_number": "855-564-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 NE TWIN KNOLLS DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014895",
            "telephone_number": "541-241-0223",
            "fax_number": "855-564-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLTON",
        "first_name": "MELISSA",
        "middle_name": "FOLEY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500685935",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "FOLEY",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 10, 2023; 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.