Amanda Jordan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60724 Issued in OR

Practice address

2635 NW Rolling Green Dr
Corvallis, OR 97330-3519

Phone

(541) 752-0545

NPI assigned

Oct 8, 2014

Last updated

Mar 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Corvallis Sport and Spine Physical Therapy IncGroup PAC ID 2961469333, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Corvallis Sport and Spine Physical Therapy Inc

  • Physical Therapist
  • Corvallis, OR
  • NPI 1841388170
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1639572316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 NW ROLLING GREEN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303519",
            "telephone_number": "541-752-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 NW ROLLING GREEN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303519",
            "telephone_number": "541-752-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60509091",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60724",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639572316",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01461874",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Fougere Jones, O.D.
• Maria Joann Jones, MD
• Michael Longpre Jones
• Mindi Dawn Jones
• S. Piper Jones, LMT
• Dean D Jordan, PA-C
• Heidi B Jordan, CATS 2
• Corynn Jorgensen
• Bao Jorgenson, DO
• Judy C Josephson, FNP

• Physical Therapist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.