Individual provider Active NPI

Martin Rodden, OTR/L

  • Occupational Therapist
  • Medford, OR
National Provider Identifier
1366884157
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
311379 Issued in OR
Practice address
1501 Prune Street
Medford, OR 97504
Phone
(503) 783-2475
NPI assigned
Jul 23, 2013
Last updated
Jul 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 311379 OR Primary

Addresses

Primary practice location

1501 Prune Street
Medford, OR 97504

Mailing address

3149 Forest Hills Dr
Apt #4
Medford, OR 97504-5788
Phone (970) 485-4537

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027001811 OR Practitioner - Occupational Therapist in Private Practice 4587010517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Occupational Therapist CurrentSince Sep 13, 2023 Accepting new patients

Locations

1010 NE Purcell Blvd
Bend, OR 97701
Phone (541) 318-6042

1025 NE Purcell Blvd
Bend, OR 97701
Phone (503) 312-4300

20215 Powers Rd
Bend, OR 97702
Phone (541) 318-3322

20225 Powers Rd
Bend, OR 97702
Phone (541) 318-3322

9000 SW 91st Ave
Tigard, OR 97223
Phone (503) 445-4363

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1366884157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 FOREST HILLS DR",
            "address_2": "APT #4",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045788",
            "telephone_number": "970-485-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 PRUNE STREET",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "503-783-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDEN",
        "first_name": "MARTIN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "311379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jul 23, 2013; 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.