Individual provider Active NPI

Evan Kepner, PT, DPT

  • Physical Therapist
  • Lebanon, OR
National Provider Identifier
1720974504
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65755 Issued in OR
Practice address
1195 S Main St
Lebanon, OR 97355-3217
Phone
(541) 401-6500
NPI assigned
Jun 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 65755 OR Primary

Addresses

Primary practice location

1195 S Main St
Lebanon, OR 97355-3217

Mailing address

9806 SW Whitford LN
Beaverton, OR 97008-6520
Phone (503) 807-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MD, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250905004090 OR Practitioner - Physical Therapist in Private Practice 5991207136 Reassigns benefits to 1 organization
I20260508000225 MD Practitioner - Physical Therapist in Private Practice 5991207136 Reassigns benefits to 1 organization
I20260508000383 DC Practitioner - Physical Therapist in Private Practice 5991207136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LHMG Physical Therapy, LLCGroup PAC ID 3870893738, 101 clinicians
Lebanon Physical Therapy LLCGroup PAC ID 3375982036, 4 clinicians

Practice addresses (Care Compare)

1153 State Route 3 N
Suite 35
Gambrills, MD 21054-1737
Phone 4102162200443292

1195 S Main St
Lebanon, OR 97355-3217
Phone (650) 235-0545

15500 Annapolis Rd
Suite 102
Bowie, MD 20715-3039
Phone (443) 481-1140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65755ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lebanon Physical Therapy, LLC Physical Therapist CurrentSince Jul 18, 2025 Accepting new patients

Locations

1195 S Main St
Lebanon, OR 97355
Phone (541) 401-6500

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": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1720974504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9806 SW WHITFORD LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086520",
            "telephone_number": "503-807-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 S MAIN ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553217",
            "telephone_number": "541-401-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPNER",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.