Benchmark Physical Therapy of Or, LLC
Organization Active NPI Physical Therapist · Wilsonville, OR
NPI 1407365331 · NPPES record last updated Sep 22, 2017
Key facts
- NPI
- 1407365331
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- BENCHMARK PHYSICAL THERAPY OF OR, LLC
- Practice address
- 8642 SW Main St Ste 130
Wilsonville, OR 97070-6585 - Phone
- (503) 855-4909
- Fax
- (503) 855-3533
- NPI assigned
- Sep 22, 2017
- Organization subpart
- No
Authorized official
- Name
- Kevin Johanneson
- Title
- VP Revenue Cycle
- Phone
- (423) 238-3220
Other NPIs on the same Medicare enrollment 19
Corporate family (same tax ID) 43
Practitioners 10
-
Laura Ahmed, PT, DPT
-
Kimberly Marie Karlsgodt, D.P.T.
-
Lars Edward Kellow, DPT
-
Joshua Thomas Lizar, PT, DPT
-
Mary Katherine Lizar, PT, DPT
-
Margaret Jane Maciuba, PT, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
8642 SW Main St Ste 130
Wilsonville, OR 97070-6585
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217
Other names
- BenchMark PT - Wilsonville
Other providers in Wilsonville, OR
- Beloved Hospice, Inc.
- Beloved Medical, LLC
- Beloved With You, LLC
- Sydney Nicole Belshe
- John Benassu
- Douglas Noland Bennett
- Kimberly Bepler
- Ashley Bertino
- Michael Alan Bevilacqua
- Angela K Binder
All providers in Wilsonville, OR · Physical Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2017. 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.