Individual provider Active NPI

Bret Kirk Reordan, D.P.T.

  • Physical Therapist
  • Jacksonville, OR
National Provider Identifier
1528414141
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61643 Issued in OR
Practice address
635 N. 5TH St.
Jacksonville, OR 97530
Phone
(541) 899-8179
Fax
(541) 899-0244
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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 61643 OR Primary

Addresses

Primary practice location

635 N. 5TH St.
Jacksonville, OR 97530

Mailing address

635 N. 5TH St.
Jacksonville, OR 97530
Phone (541) 899-8179

Other identifiers 1

IdentifierTypeStateIssuer
500708227MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160712000940 OR Practitioner - Physical Therapist in Private Practice 2466744412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reordan Physcial Therapy, IncGroup PAC ID 1456435346, 4 clinicians

Practice addresses (Care Compare)

635 N 5TH St
Jacksonville, OR 97530-9659
Phone (541) 899-8179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist CurrentSince Jun 1, 2016 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Jun 1, 2016 Accepting new patients
Reordan Physcial Therapy, Inc CurrentSince Dec 1, 2018 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

635 N 5th St
Jacksonville, OR 97530
Phone (541) 889-8179

5955 Shoreview Ln N
Ste 100
Keizer, OR 97303
Phone (503) 463-4221

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

Organizations & group practices 6

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1528414141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N. 5TH ST.",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "97530",
            "telephone_number": "541-899-8179",
            "fax_number": "541-899-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N. 5TH ST.",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "97530",
            "telephone_number": "541-899-8179",
            "fax_number": "541-899-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REORDAN",
        "first_name": "BRET",
        "middle_name": "KIRK",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500708227",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.