Two Rivers Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

38130399 Issued in OR

Legal business name

TWO RIVERS PHYSICAL THERAPY, LLC

Practice address

7522 N Lombard St Ste a
Portland, OR 97203-3235

Phone

(503) 445-7878

Fax

(503) 445-7879

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

C. Thomas Provenzano, MPT

Title

Owner

Phone

(503) 445-7878

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexander C Henningsen, DPT

  • Physical Therapist
  • Portland, OR
  • NPI 1598285561
  Medicare reassignment Care Compare group NPD
• Julie McAllister, MSPT

  • Physical Therapist
  • Portland, OR
  • NPI 1114908571
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1255473047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7522 N LOMBARD ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033235",
            "telephone_number": "503-445-7878",
            "fax_number": "503-445-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7522 N LOMBARD ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033235",
            "telephone_number": "503-445-7878",
            "fax_number": "503-445-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "PROVENZANO",
        "authorized_official_first_name": "C. THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-445-7878",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "38130399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twinflower Counseling LLC
• James Aaron Twinn
• Roger Twitchell
• Two Eyed Healing LLC
• Loki Two Owls, CADC-R CRM
• Anaiyah Victoria Twotwo
• James Francis Tycast, M.D.
• Ella Meghan Tycz
• Arin Katarina Tyler
• Guy Thomas Tyler, LCSW

• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.