Individual provider Active NPI

Brian E. Winkler, P.T.

  • Physical Therapist
  • Medford, OR
National Provider Identifier
1265432256
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02952 Issued in OR
Practice address
70 Bower Drive
Medford, OR 97501-9848
Phone
(541) 734-3430
Fax
(541) 734-3638
NPI assigned
Jul 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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 02952 OR Primary

Addresses

Primary practice location

70 Bower Drive
Medford, OR 97501-9848

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (541) 734-3430

Other practice location 1

3512 Excel Dr
Suite 105
Medford, OR 97504-9848
Phone (541) 476-1919

Other identifiers 1

IdentifierTypeStateIssuer
228746MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwinkler789736@oc.providencedirect.org

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
02952ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Apr 17, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 17, 2017 Accepting new patients

Locations

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

Interoperability endpoints

  • Direct secure messaging: bwinkler789736@oc.providencedirect.org

Organizations & group practices 2

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": "1122768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1265432256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "541-734-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BOWER DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975019848",
            "telephone_number": "541-734-3430",
            "fax_number": "541-734-3638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3512 Excel Dr",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975049848",
            "country_code": "US",
            "telephone_number": "541-476-1919",
            "fax_number": "541-476-1920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINKLER",
        "first_name": "BRIAN",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-31",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "02952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228746",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwinkler789736@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "965 Ellendale Dr",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975048215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.