NPIMap

Organization Active NPI

Therapeutic Associates, Inc

Doing business as TAI - La Pine

  • Physical Therapist
  • La Pine, OR
National Provider Identifier
1578054748
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
THERAPEUTIC ASSOCIATES, INC
Doing business as
TAI - La Pine
Practice address
51681 Huntington Rd
La Pine, OR 97739
Phone
(541) 536-6122
Fax
(541) 536-6123
NPI assigned
May 23, 2018
Last updated
Aug 20, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
THERAPEUTIC ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Authorized official

Name
Todd GiffordNPI 1770933061
Title
Ceo
Phone
(503) 443-6156

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

51681 Huntington Rd
La Pine, OR 97739

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other identifiers 1

IdentifierTypeStateIssuer
500745900MedicaidOR

Other names 1

  • TAI - La Pine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000432 OR Part B Supplier - Clinic/Group Practice 0042116279 Receives reassigned benefits from 305 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Central Physical Therap100 organizations share this tax ID, including this one
Part of
Central Physical Therap

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1578054748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51681 HUNTINGTON RD",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "97739",
            "telephone_number": "541-536-6122",
            "fax_number": "541-536-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC ASSOCIATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THERAPEUTIC ASSOCIATES, INC",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "GIFFORD",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-443-6156"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500745900",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAI - La Pine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Pine, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.