Individual provider Active NPI

Carla Jane Horton, PT

  • Physical Therapist
  • Eugene, OR
National Provider Identifier
1770565624
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2986 Issued in OR
Practice address
4242 Commerce St
Ste a
Eugene, OR 97402-5412
Phone
(541) 484-9632
Fax
(541) 484-7466
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2986 OR Primary
Physical Therapist 225100000X RPT719 ID

Addresses

Primary practice location

4242 Commerce St
Ste a
Eugene, OR 97402-5412

Mailing address

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other identifiers 1

IdentifierTypeStateIssuer
275341MedicaidOR

Other names 1

  • Carla Jane Roodzant Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000207 OR Practitioner - Physical Therapist in Private Practice 5799763553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

2911 Tennyson Ave
Suite 204
Eugene, OR 97408-4693
Phone (541) 515-6194

890 Seneca Rd
Suite 700
Eugene, OR 97402-6908
Phone (541) 484-9632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RPT719IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Apr 22, 2004 Accepting new patients
Therapeutic Associates, Inc Physical Therapist CurrentSince Apr 22, 2004 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

4242 Commerce St
Ste A
Eugene, OR 97402
Phone (541) 484-9632

2911 Tennyson Ave
Ste 204
Eugene, OR 97408
Phone (541) 515-6194

1307 NE 102nd Ave
Ste G
Portland, OR 97220
Phone (503) 253-0924

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

Interoperability endpoints

  • Direct secure messaging: carla.horton.1@31414.direct.athenahealth.com

Organizations & group practices 6

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1770565624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 COMMERCE ST",
            "address_2": "STE A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025412",
            "telephone_number": "541-484-9632",
            "fax_number": "541-484-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "CARLA",
        "middle_name": "JANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2986",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "RPT719",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275341",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "ROODZANT",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.