NPIMap

Organization Active NPI

Alevia Physical Therapy LLC

  • Physical Therapist
  • Medford, OR
National Provider Identifier
1679959571
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ALEVIA PHYSICAL THERAPY LLC
Practice address
1345 Center Dr Ste 100
Medford, OR 97501-7945
Phone
(541) 210-5674
Fax
(541) 210-5674
NPI assigned
Aug 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Jordan Christopher Spence, PT, DPTNPI 1417320615
Title
Ceo
Phone
(541) 210-5674

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1345 Center Dr Ste 100
Medford, OR 97501-7945

Mailing address

1345 Center Dr Ste 100
Medford, OR 97501-7945
Phone (541) 210-5674

Other identifiers 1

IdentifierTypeStateIssuer
500705016MedicaidOR

Other names 1

  • Alevia Physical Therapy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@aleviapt.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151002000742 OR Part B Supplier - Clinic/Group Practice 8820306319 Receives reassigned benefits from 3 practitioners
Practice locations: Medford, OR

National Provider Directory

National Provider Directory

Locations

1345 Center Dr
Ste 100
Medford, OR 97501
Phone (541) 210-5674

618 Crater Lake Ave
Medford, OR 97504
Phone (541) 991-4271

310 Crater Lake Ave
Ste 102
Medford, OR 97504
Phone (541) 210-5674

1345 Center Dr
Unit A
Medford, OR 97501
Phone (541) 210-5674

Practitioners & affiliated clinicians

Practitioners 12

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": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1679959571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 CENTER DR STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017945",
            "telephone_number": "541-210-5674",
            "fax_number": "541-210-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 CENTER DR STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017945",
            "telephone_number": "541-210-5674",
            "fax_number": "541-210-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEVIA PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-210-5674",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500705016",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@aleviapt.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1345 Center Dr Ste 100",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975017945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Alevia Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alevia Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 16, 2023; 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.