NPIMap

Organization Active NPI

Trails End Physical Therapy, LLC

  • Physical Therapist
  • Oregon City, OR
National Provider Identifier
1497872022
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1851 Issued in OR
Legal business name
TRAILS END PHYSICAL THERAPY, LLC
Practice address
1506 Washington St
Oregon City, OR 97045-1450
Phone
(503) 655-6777
Fax
(503) 655-6778
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Authorized official

Name
Dawn Marie Klein, MSPTNPI 1821008129
Title
Physical Therapist
Phone
(503) 655-6777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 1851 OR Primary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X 10635 OR

Addresses

Primary practice location

1506 Washington St
Oregon City, OR 97045-1450

Mailing address

1506 Washington St
Oregon City, OR 97045-1450
Phone (503) 655-6777

Other identifiers 1

IdentifierTypeStateIssuer
298959MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060106000163 OR Part B Supplier - Clinic/Group Practice 2365465283 Receives reassigned benefits from 1 practitioner
Practice locations: Oregon City, OR

National Provider Directory

National Provider Directory

Locations

1506 Washington St
Oregon City, OR 97045
Phone (503) 655-6777

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1497872022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 WASHINGTON ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451450",
            "telephone_number": "503-655-6777",
            "fax_number": "503-655-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 WASHINGTON ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451450",
            "telephone_number": "503-655-6777",
            "fax_number": "503-655-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAILS END PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "503-655-6777",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "1851",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "10635",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.