Individual provider Active NPI

Keaton Tyler Fournier, DPT

  • Physical Therapist
  • Ashland, OR
National Provider Identifier
1376403188
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65782 Issued in OR
Practice address
579 Walker Ave
Ashland, OR 97520-2382
Phone
(541) 708-6171
NPI assigned
Nov 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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 65782 OR Primary

Addresses

Primary practice location

579 Walker Ave
Ashland, OR 97520-2382

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260105002616 OR Practitioner - Physical Therapist in Private Practice 6709372287 Reassigns benefits to 1 organization
Practice locations: Ashland, OR

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of Oregon LLCGroup PAC ID 0143510602, 124 clinicians

Practice addresses (Care Compare)

579 Walker Ave
Ashland, OR 97520-2382
Phone (541) 708-6171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65782ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

579 Walker Ave
Ashland, OR 97520
Phone (541) 708-6171

1777 Coburg Rd
Ste 3
Eugene, OR 97401
Phone (541) 505-8041

440 1st St
Lake Oswego, OR 97034
Phone (503) 744-4826

3007 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-6252

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

365 Westfield St
Silverton, OR 97381
Phone (503) 873-6111

Organizations & group practices 3

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": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1376403188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 WALKER AVE",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202382",
            "telephone_number": "541-708-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURNIER",
        "first_name": "KEATON",
        "middle_name": "TYLER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.