Ethan Vosburgh, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

117 McNary Estates Dr N
Keizer, OR 97303-7459

Phone

(503) 400-7717

NPI assigned

Sep 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benchmark Physical Therapy of Oregon LLCGroup PAC ID 0143510602, 124 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1801257191
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Roseburg, OR
  • NPI 1427524388
  NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Cave Junction, OR
  • NPI 1467996363
  NPD

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1760153506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MCNARY ESTATES DR N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973037459",
            "telephone_number": "503-400-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOSBURGH",
        "first_name": "ETHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12296564-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Vasas, LMT
• Alma Denise Vera, RDH
• Kathy Ann Verboort, COTA/A
• Stephanie Lynn Vieu, M.S., LPC, CADC II
• Vitality Spa LLC
• Margaret Diane Wade, MSW, LCSW
• Walgreen Co
• Stephen Dale Walter, DC
• Jeffrey T Wang, M.D.
• Andrea Ward, PMHNP

• Physical Therapist in Keizer, OR
• Providers in Keizer, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.