NPIMap

Organization Active NPI

Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Wilsonville, OR
National Provider Identifier
1407365331
Registry record updated Sep 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 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
Last updated
Sep 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2017

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

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-3220

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
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 1

  • BenchMark PT - Wilsonville Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Benchmark Physical Therapy of Oregon LLC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

8642 SW Main St
Ste 130
Wilsonville, OR 97070
Phone (503) 685-9841

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506038400000",
    "number": "1407365331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8642 SW MAIN ST STE 130",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970706585",
            "telephone_number": "503-855-4909",
            "fax_number": "503-855-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENCHMARK PHYSICAL THERAPY OF OR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-22",
        "last_updated": "2017-09-22",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "423-238-3220"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BenchMark PT - Wilsonville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.