Individual provider Active NPI

Jordan Christopher Spence, PT, DPT

  • Physical Therapist
  • Medford, OR
National Provider Identifier
1417320615
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1345 Center Dr Ste 100
Medford, OR 97501-7945
Phone
(541) 210-5674
NPI assigned
Nov 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X OR Primary

Addresses

Primary practice location

1345 Center Dr Ste 100
Medford, OR 97501-7945

Mailing address

1345 Center Dr Ste 100
Medford, OR 97501-7945
Phone (541) 210-5674

Other practice location 1

730 Biddle Rd
Medford, OR 97504-6116
Phone (541) 535-6239

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170630002561 OR Practitioner - Physical Therapist in Private Practice 1759682784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alevia Physical Therapy LLCGroup PAC ID 8820306319, 3 clinicians

Practice addresses (Care Compare)

1345 Ctr Dr
Unit a
Medford, OR 97501-7945
Phone (541) 210-5674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alevia Physical Therapy LLC Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients

Locations

1345 Center Dr
Ste 100
Medford, OR 97501
Phone (541) 210-5674

730 Biddle Rd
Medford, OR 97504
Phone (541) 210-5674

1345 Center Dr
Unit A
Medford, OR 97501
Phone (541) 210-5674

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1417320615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 CENTER DR STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017945",
            "telephone_number": "541-210-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 CENTER DR STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017945",
            "telephone_number": "541-210-5674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Biddle Rd",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046116",
            "country_code": "US",
            "telephone_number": "541-535-6239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "JORDAN",
        "middle_name": "CHRISTOPHER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-10",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.