Active NPI
Bruce K Lawrence, D.P.T
- Physical Therapist
- Medford, OR
National Provider Identifier
1629466800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 06711
- Practice address
- 965 Ellendale Dr
Medford, OR 97504 - Phone
- (541) 734-3450
- NPI assigned
- Dec 23, 2014
- 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 | 06711 | OR | Primary |
Addresses
Primary practice location
965 Ellendale Dr
Medford, OR 97504
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (541) 732-3450
Other practice location 1
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Phone (971) 224-2838
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler | Other | Fox Rehabilitation Services TN LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
7 Clyde Rd
Somerset, NJ 08873-5049
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06711 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services TN LLC | Physical Therapist | Current | Accepting new patients |
Locations
3056 Miles Johnson Pkwy
Spring Hill, TN 37174
Phone (931) 451-0009
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.
-
- Physical Therapist
- Spring Hill, TN
- NPI 1710406491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769990400000",
"number": "1629466800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "541-732-3450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 ELLENDALE DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "97504",
"telephone_number": "541-734-3450"
}
],
"practiceLocations": [
{
"address_1": "25117 SW Parkway Ave Ste D",
"address_purpose": "LOCATION",
"city": "Wilsonville",
"state": "OR",
"postal_code": "970709697",
"country_code": "US",
"telephone_number": "971-224-2838",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAWRENCE",
"first_name": "BRUCE",
"middle_name": "K",
"credential": "D.P.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-23",
"last_updated": "2026-02-02",
"certification_date": "2026-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "06711",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
"affiliationName": "Fox Rehabilitation Services TN LLC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "3056 Miles Johnson Pkwy",
"city": "Spring Hill",
"state": "TN",
"country_code": "US",
"postal_code": "371744564",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.