Trevor Bodine, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

7976 Issued in OR

Practice address

3270 Liberty Rd. S
Salem, OR 97302

Phone

(503) 371-0779

Fax

(530) 371-0886

NPI assigned

Mar 5, 2013

Sex

Male

Sole proprietor

No

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.

• Northwest Rehabilitation Associates, Inc.

  • Physical Therapy Clinic/Center
  • West Salem, OR
  • NPI 1972505790
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 5, 2013.

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1376884098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 LIBERTY RD. S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-371-0779",
            "fax_number": "530-371-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 LIBERTY RD. S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-371-0779",
            "fax_number": "530-371-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODINE",
        "first_name": "TREVOR",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "7976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily C Bobbitt, LMT
• Julie Bochsler
• Summer Sunshine Bock, LMT
• Nathan K. Boddie, M.D., M.S.
• Kevin Dale Bodin, QMHA, C.A.D.C. I
• Peter Bodmer
• Ekaterina Bodunov
• Victoria Boechler, PT, DPT
• Timothy John Boehm, DMD
• Gary W Boehne, DMD

• All providers in Salem, OR
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.