Southwest Physical Therapy

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

SOUTHWEST PHYSICAL THERAPY

Practice address

913 11TH St SE
Suite 1
Bandon, OR 97411-9168

Phone

(541) 347-4314

NPI assigned

Apr 10, 2007

Last updated

Sep 24, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Cory Dorland

Title

Business Manager

Phone

(541) 269-7212

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southwests Physical Therapy & John Breuer Rehabilitation Services Other name

Tax ID family

John Breuer Rehab Services6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Southwest Physical Therapy

  dba Gold Beach Physical Therapy & Rehab

  • Rehabilitation Clinic/Center
  • Gold Beach, OR
  • NPI 1497979785
  NPD tax ID
• Southwest Physical Therapy

  dba Brookings Harbor Physical Therapy & Rehab

  • Rehabilitation Clinic/Center
  • Brookings, OR
  • NPI 1518181809
  NPD tax ID
• Southwest Physical Therapy LLC

  dba John Breuer Rehab Services

  • Occupational Medicine Clinic/Center
  • Coos Bay, OR
  • NPI 1306230917
  NPD tax ID
• Southwest Physical Therapy LLC

  • Rehabilitation Clinic/Center
  • Coquille, OR
  • NPI 1568685766
  NPD tax ID
• Southwest Physical Therapy LLC

  dba John Breuer Rehab Services

  • Rehabilitation Clinic/Center
  • Coos Bay, OR
  • NPI 1851407464
  NPD tax ID

Locations

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1669695854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 11TH ST SE",
            "address_2": "SUITE 1",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974119168",
            "telephone_number": "541-347-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 11TH ST SE",
            "address_2": "SUITE 1",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974119168",
            "telephone_number": "541-347-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "DORLAND",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "541-269-7212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052105",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwests Physical Therapy & John Breuer Rehabilitation Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Paul Edward Smith, PT, DPT
• Venus Crystal Smith, D.C
• Southern Coos Health District (Southern Coos Hospital & Health Center)
• Southern Coos Health District
• Southern Coos Health District (SCHHC Retail Pharmacy)
• Mara Maria Spang, LMT
• Richard Kelly Staggenborg, MD
• Richard A. Standiford, LCSW
• Sunshine Chiropractic Center, PC.
• James Ryan Surface, DMD

• Rehabilitation Clinic/Center in Bandon, OR
• Providers in Bandon, OR by specialty
• Rehabilitation Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.