Individual provider Active NPI

Theresa Ann Shipley-Klein, P.T.

  • Physical Therapist
  • Roseburg, OR
National Provider Identifier
1689818353
Registry record updated Apr 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1298 Issued in OR
Practice address
913 NW Garden Valley Blvd
Roseburg, OR 97471-6523
Phone
(541) 440-1000
NPI assigned
Apr 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1298 OR Primary

Addresses

Primary practice location

913 NW Garden Valley Blvd
Roseburg, OR 97471-6523

Mailing address

244 Julina LN
Roseburg, OR 97471-9541
Phone (541) 580-2261

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170413002224 HI Practitioner - Physical Therapist in Private Practice 7719975853 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaiian Rehabilitation Services IncGroup PAC ID 5799811345, 10 clinicians

Practice addresses (Care Compare)

75 -137 Hualalai Rd
Kailua Kona, HI 96740-3722
Phone (808) 329-0591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1298ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaiian Rehabilitation Services Inc Physical Therapist CurrentSince Apr 1, 2017 Accepting new patients
Club Rehab, Inc. Physical Therapist CurrentSince May 1, 2019 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

75-165 Hualalai Rd
Kailua Kona, HI 96740
Phone (808) 329-0591

73-5590 Kauhola St
Ste A
Kailua Kona, HI 96740

75-5699 Kopiko St
Kailua Kona, HI 96740
Phone (808) 329-7744

79-7422 Mamalahoa Hwy
Kealakekua, HI 96750
Phone (808) 322-8400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1240704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240704000000",
    "number": "1689818353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 JULINA LN",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974719541",
            "telephone_number": "541-580-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716523",
            "telephone_number": "541-440-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY-KLEIN",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-26",
        "last_updated": "2009-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "1298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2009; 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.