NPIMap

Organization Active NPI

Northeast Oregon Physical Therapy, LLC

  • Physical Therapist
  • La Grande, OR
National Provider Identifier
1679907281
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0557 Issued in OR
Legal business name
NORTHEAST OREGON PHYSICAL THERAPY, LLC
Practice address
301 4TH St
La Grande, OR 97850-1901
Phone
(541) 963-9340
Fax
(541) 963-4562
NPI assigned
Aug 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Authorized official

Name
S Dale Johnston, PT
Title
Owner/Physical Therapist
Phone
(541) 963-9340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 0557 OR Primary

Addresses

Primary practice location

301 4TH St
La Grande, OR 97850-1901

Mailing address

301 4TH St
La Grande, OR 97850-1901
Phone (541) 963-9340

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1679907281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 4TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501901",
            "telephone_number": "541-963-9340",
            "fax_number": "541-963-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 4TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501901",
            "telephone_number": "541-963-9340",
            "fax_number": "541-963-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OREGON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "S",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "541-963-9340",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "0557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.