Benchmark Physical Therapy of Or, LLC
Organization Active NPI Physical Therapist · Ashland, OR
NPI 1366935702 · NPPES record last updated Jun 11, 2018
Key facts
- NPI
- 1366935702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- BENCHMARK PHYSICAL THERAPY OF OR, LLC
- Practice address
- 579 Walker Ave
Ashland, OR 97520-2382 - Phone
- (833) 881-9258
- NPI assigned
- Jun 11, 2018
- Organization subpart
- No
Authorized official
- Name
- Kevin Johanneson
- Title
- VP Revenue Cycle
- Phone
- (423) 238-2313
Other NPIs on the same Medicare enrollment 19
Corporate family (same tax ID) 43
Practitioners 16
-
Jessica Allen, DPT
-
Tiffany Conway, DPT
-
Jonathan Blake, DPT
-
Kayla Contardi, DPT
-
Natalia Gil, MS, OTR/L
-
Coulson Lash, PT, DPT
-
Connor Roman Longacre, PT,DPT
-
Michael Craig Mahan, PT, DPT
-
Logan Reddy, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160613001008 | OR | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 0143510602 |
Receives reassigned benefits from 236 practitioners 19 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Salem, OR; Medford, OR; Milwaukie, OR; Molalla, OR; Gresham, OR; Oregon City, OR; Pacific City, OR; Prineville, OR… |
National Provider Directory
- Tax ID family
- Benchmark Physical Therapy of Oregon LLC
Locations
579 Walker Ave
Ashland, OR 97520
Phone (541) 708-6171
5075 River Rd N
Keizer, OR 97303
Phone (503) 400-7717
3007 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-6252
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
579 Walker Ave
Ashland, OR 97520-2382
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.