Jennifer Bissig, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5844 Issued in OR

Practice address

365 S Redwood St
Canby, OR 97013-2405

Phone

(503) 651-2020

NPI assigned

Feb 20, 2007

Last updated

Nov 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Lake Physical Therapy and Rehab LPGroup PAC ID 4082853825, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Lake Physical Therapy and Rehab LP

  • Physical Therapist
  • Lake Oswego, OR
  • NPI 1316383201
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1285779249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 S REDWOOD ST",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970132405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 S REDWOOD ST",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970132405",
            "telephone_number": "503-651-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSIG",
        "first_name": "JENNIFER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.014953",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34421",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Joy Bekedam
• Sean L Bennett, DPT
• Christopher M Berberian, MD
• Nancy Ellen Bernstetter, RN
• Daniel Birt, MMT, MT-BC/L, QMHP
• Anna Fehm Blake, RN
• Dianne Eileen Blust, ANP
• Tyler Marc Bohnet, MPT
• Gary M Bold, RPH
• Misty M Bonham, LCSW

• Physical Therapist in Canby, OR
• Providers in Canby, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.