Rhandi Jackson
Individual provider Active NPI Physical Therapist · Estacada, OR
NPI 1407647274 · NPPES record last updated May 13, 2025
Key facts
- NPI
- 1407647274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- CP044280T (OR)
- Practice address
- 180 SE Highway 224
Estacada, OR 97023-7022 - Phone
- (503) 698-5500
- NPI assigned
- May 13, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
121 S Highland St
Winchester, KY 40391-2003
2010 W Katherine P Raines Rd
Suite 300
Cleburne, TX 76033-7447
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250912001679 | TX | Practitioner - Physical Therapist in Private Practice | 4082117247 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP037015T | AZ | MD | Physical Therapist |
| 307507 | CA | MD | Physical Therapist |
| CP044280T | OR | MD | Physical Therapist |
| 1346277 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chisholm Trail Orthopedics & Sports Medicine, LLLP | Current |
Accepting new patients | |
| Chisholm Trail Orthopedics & Sports Medicine, LLLP | Current |
Accepting new patients | |
| Clackamas Physical Therapy Associates, Inc. | Current |
Accepting new patients |
Locations
2010 W Katherine P Raines Rd
Ste 400
Cleburne, TX 76033
Phone (817) 357-8006
2010 W Katherine P Raines Rd
Ste 300
Cleburne, TX 76033
Phone (817) 556-3212
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1346277 | TX | |
| Physical Therapist | 225100000X | 307507 | CA | |
| Physical Therapist | 225100000X | CP037015T | AZ | |
| Physical Therapist | 225100000X | CP044280T | OR | Yes |
Addresses
Primary practice location
180 SE Highway 224
Estacada, OR 97023-7022
Mailing address
655 S Willow St
Manchester, NH 03103-5714
Other providers in Estacada, OR
- Josh Hansen
- Paul S Hansen
- Hillsboro Family Behavioral Health, LLC
- Casondra Lee Hults
- Candice Lyn Hunter
- Susan M. Jones
- Amy M Kammerer
- Amrita Kang
- Brittany Marie Kyle
- Stephanie Marie Kyle
All providers in Estacada, 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 May 13, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.