Active NPI
Gregory J. Redfern, P.T.
- Physical Therapist
- Grants Pass, OR
National Provider Identifier
1457351447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3581
- Practice address
- 625 Ramsey Ave
Suite B
Grants Pass, OR 97527-5808 - Phone
- (541) 476-1919
- Fax
- (541) 476-1920
- NPI assigned
- Jul 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3581 | OR | Primary |
Addresses
Primary practice location
625 Ramsey Ave
Suite B
Grants Pass, OR 97527-5808
Mailing address
625 Ramsey Ave
Suite B
Grants Pass, OR 97527-5808
Phone (541) 476-1919
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 182072 | Medicaid | OR | |
| 1897777 | Other | OR | UNITED HEALTH CARE INSURA |
| J284203 | Other | OR | PACIFIC SOURCE INSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3581 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kab Physical Therapy LLC | Physical Therapist | Past | Accepting new patients |
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.
-
dba Impact Physical Therapy of Hillsboro
- Physical Therapist
- Hillsboro, OR
- NPI 1447568183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196899200000",
"number": "1457351447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 RAMSEY AVE",
"address_2": "SUITE B",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275808",
"telephone_number": "541-476-1919",
"fax_number": "541-476-1920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 RAMSEY AVE",
"address_2": "SUITE B",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275808",
"telephone_number": "541-476-1919",
"fax_number": "541-476-1920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDFERN",
"first_name": "GREGORY",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-31",
"last_updated": "2007-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "3581",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "182072",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE INSURA",
"identifier": "1897777",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFIC SOURCE INSURANCE",
"identifier": "J284203",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.