Individual provider Active NPI

Brian Keith Chambers, MPT

  • Physical Therapist
  • Pendleton, OR
National Provider Identifier
1720071897
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3672 Issued in OR
Practice address
1100 Southgate
#1
Pendleton, OR 97801-3974
Phone
(541) 276-4011
Fax
(541) 278-2327
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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 3672 OR Primary

Addresses

Primary practice location

1100 Southgate
#1
Pendleton, OR 97801-3974

Mailing address

PO Box 307
Bountiful, UT 84011-0307
Phone (801) 294-6907

Other identifiers 1

IdentifierTypeStateIssuer
227840MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060209000460 OR Practitioner - Physical Therapist in Private Practice 4789699935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Oregon Physical TherapyGroup PAC ID 8729072350, 3 clinicians

Practice addresses (Care Compare)

1100 Southgate
Suite 15
Pendleton, OR 97801-3971
Phone (541) 276-4011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3672ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Oregon Physical Therapy Physical Therapist CurrentSince Nov 15, 2001 Accepting new patients
Rocky Mountain Therapy Services Texas LLC Physical Therapist PastSince Jul 1, 2011 Accepting new patients

Locations

1100 Southgate
Ste 1
Pendleton, OR 97801
Phone (541) 276-4011

1100 Southgate
Ste 15
Pendleton, OR 97801
Phone (541) 276-4011

Organizations & group practices 2

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1720071897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SOUTHGATE",
            "address_2": "#1",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013974",
            "telephone_number": "541-276-4011",
            "fax_number": "541-278-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227840",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.