Siskiyou Physical Therapy, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4659 Issued in OR

Legal business name

SISKIYOU PHYSICAL THERAPY, PC

Practice address

1485 NE 7TH St
Grants Pass, OR 97526

Phone

(541) 479-6936

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Marcelle Hull, DO

Title

Biller

Phone

(541) 479-6936

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 5

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

• Jesse Elliott, DPT

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1205868817
  Medicare reassignment Care Compare group NPD
• Jonathan Aaron Hill, P.T., DPT

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1780844647
  Medicare reassignment Care Compare group NPD
• Ian Rousseau, PT

  • Physical Therapist
  • Medford, OR
  • NPI 1609635846
  Medicare reassignment NPD
• Garrett Jack Hoggarth, PTA

  • Physical Therapy Assistant
  • Grants Pass, OR
  • NPI 1295258929
  NPD (past)
• Douglas Mitchell, D.P.T.

  • Physical Therapist
  • Sun Lakes, AZ
  • NPI 1922131606
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1730233099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2630",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975280239",
            "telephone_number": "541-479-6936",
            "fax_number": "541-479-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-479-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISKIYOU PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "HULL",
        "authorized_official_first_name": "MARCELLE",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "541-479-6936",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000584",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Siskiyou Community Health Center Inc
• Siskiyou Community Health Center Pharmacy
• Siskiyou Community Health Center, Inc
• Siskiyou Community Health Center, Inc (Siskiyou Community Health Center Pharmacy)
• Siskiyou Pediatric Clinic, LLP
• Toni Erin Skaggs I, LMT
• Sleepytime Anesthesia
• Shayna Roschelle Sleight, MD
• Amanda Evans Sloan, LCSW
• Lindsey Smaw, QMHA

• Physical Therapist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.