Active NPI
Therapeutic Associates Inc
Doing business as Therapeutic Associates Kings Road Physical Therapy
- Physical Therapist
- Corvallis, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- THERAPEUTIC ASSOCIATES INC
- Doing business as
- Therapeutic Associates Kings Road Physical Therapy
- Practice address
- 996 NW Circle Blvd
Suite 101
Corvallis, OR 97330-1410 - Phone
- (541) 757-0878
- Fax
- (541) 757-0879
- NPI assigned
- Dec 19, 2005
- Last updated
- Oct 29, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Todd Robert Gifford, PT
- Title
- Information Systems Director
- Phone
- (503) 443-6156
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | OR | Primary | |
| Occupational Therapist | 225X00000X |
Addresses
Primary practice location
996 NW Circle Blvd
Suite 101
Corvallis, OR 97330-1410
Mailing address
16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other names 1
- Therapeutic Associates Kings Road Physical Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040205000432 | OR | Part B Supplier - Clinic/Group Practice | 0042116279 |
Receives reassigned benefits from 305 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Tigard, OR
- NPI 1770933061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1351468800000",
"number": "1366428757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD",
"address_2": "STE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "800-219-8835",
"fax_number": "503-639-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "996 NW CIRCLE BLVD",
"address_2": "SUITE 101",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973301410",
"telephone_number": "541-757-0878",
"fax_number": "541-757-0879"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THERAPEUTIC ASSOCIATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-19",
"last_updated": "2012-10-29",
"status": "A",
"authorized_official_last_name": "GIFFORD",
"authorized_official_first_name": "TODD",
"authorized_official_middle_name": "ROBERT",
"authorized_official_title_or_position": "INFORMATION SYSTEMS DIRECTOR",
"authorized_official_telephone_number": "503-443-6156",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "OR",
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Therapeutic Associates Kings Road Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.