Individual provider Active NPI

Justin Lee Thomas, DPT

  • Physical Therapist
  • Klamath Falls, OR
National Provider Identifier
1518439470
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211630 Issued in VA
Practice address
2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone
(541) 882-6311
NPI assigned
Dec 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 63063 OR
Physical Therapist 225100000X 2305211630 VA Primary

Addresses

Primary practice location

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Mailing address

1121 Lady Ginger LN
Virginia Beach, VA 23455-5657
Phone (757) 831-2834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CO, AK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221117000598 VA Practitioner - Physical Therapist in Private Practice 4082037981 Reassigns benefits to 1 organization
I20230808003372 CO Practitioner - Physical Therapist in Private Practice 4082037981 Reassigns benefits to 1 organization
I20240328003532 AK Practitioner - Physical Therapist in Private Practice 4082037981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salida Hospital DistrictGroup PAC ID 3577451152, 100 clinicians

Practice addresses (Care Compare)

704 Edwards Ave
Westcliffe Rehab Services
Westcliffe, CO 81252-8588
Phone (719) 783-2380

Merit-based Incentive Payment System (MIPS)

Final score
75.69 of 100Reported as group
Quality
71.4
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63063ORMDPhysical Therapist
2305211630VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salida Hospital District CurrentSince Jun 5, 2023 Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Oct 12, 2022 Accepting new patients
Salida Hospital District CurrentSince Jun 5, 2023 Accepting new patients
Optimum Health and Wellness Physical Therapy, Inc. Physical Therapist CurrentSince Feb 25, 2024 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Oct 12, 2022 Accepting new patients
Select Physical Therapy Holdings, Inc. Physical Therapist Current Accepting new patients
Salida Hospital District Current Accepting new patients
Gulf Breeze Physical Therapy Inc. Physical Therapist Past Accepting new patients

Locations

4079 Tongass Ave
Ste 102
Ketchikan, AK 99901
Phone (907) 225-7808

1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265

704 Edwards Ave
Westcliffe, CO 81252
Phone (719) 545-1607

250 Merchant Walk Ave
Charlottesville, VA 22902

2303 N Augusta St
Ste E
Staunton, VA 24401
Phone (540) 886-4510

Organizations & group practices 8

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1518439470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 LADY GINGER LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555657",
            "telephone_number": "757-831-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-882-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63063",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.