Mojo Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

60894 Issued in OR

Legal business name

MOJO PHYSICAL THERAPY LLC

Practice address

2211 NW Professional Dr
Suite 204
Corvallis, OR 97330-3891

Phone

(541) 207-3720

Fax

(541) 207-3729

NPI assigned

Jun 8, 2016

Organization subpart

No

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

Authorized official

Name

James Kevin Thomason, PTNPI 1104088590

Title

Pwner

Phone

(541) 915-3811

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Kevin Thomason, PT

  • Physical Therapist
  • Eugene, OR
  • NPI 1104088590
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1376992594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 NW PROFESSIONAL DR",
            "address_2": "SUITE 204",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303891",
            "telephone_number": "541-207-3720",
            "fax_number": "541-207-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 NW PROFESSIONAL DR",
            "address_2": "SUITE 204",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303891",
            "telephone_number": "541-207-3720",
            "fax_number": "541-207-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOJO PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "THOMASON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PWNER",
        "authorized_official_telephone_number": "541-915-3811",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "60894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn L Moen, P.T
• Kristin Elizabeth Moen, RN, DNP, PMHNP-BC
• Taylor Moffatt
• Nada Mohamed
• Mohammed S Mohammed, M.D.
• Shawn Moling, MA
• John J Molitor Jr., MD
• Gabrielle Monaco, BS
• Shannon Mong, PSY.D.
• Monroe Ave Dental Care

• Physical Therapy Clinic/Center in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.