Individual provider Active NPI

Thad G Harlow, M.P.T.

  • Physical Therapist
  • Medford, OR
National Provider Identifier
1790897015
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8350 Issued in CO
Practice address
1111 Crater Lake Ave
Medford, OR 97504
Phone
(970) 361-0008
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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 8350 CO Primary

Addresses

Primary practice location

1111 Crater Lake Ave
Medford, OR 97504

Mailing address

3126 Alameda St Unit 306
Medford, OR 97504-8678
Phone (709) 361-0008

Other practice location 1

3832 E Main St
suite E
Farmington, NM 87402-8749
Phone (505) 258-4003

Other practice location 2

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (970) 361-0008

Other practice location 3

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (970) 361-0008

Other identifiers 3

IdentifierTypeStateIssuer
840999425011OtherCOROCKY MOUNTAIN HMO NUMBER
P00376779OtherCOMEDICARE, RAILROAD
840999425OtherCOTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Valley Rehabilitation, PC Past Accepting new patients
Tail Wind Therapies PC Physical Therapist PastSince Jul 1, 2012 Accepting new patients
Cardiac Ultrasound, Inc Past Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1790897015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 ALAMEDA ST UNIT 306",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048678",
            "telephone_number": "709-361-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "970-361-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3832 E Main St",
            "address_2": "suite E",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874028749",
            "country_code": "US",
            "telephone_number": "505-258-4003",
            "fax_number": "505-436-2740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Crater Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046241",
            "country_code": "US",
            "telephone_number": "970-361-0008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Crater Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046241",
            "country_code": "US",
            "telephone_number": "970-361-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARLOW",
        "first_name": "THAD",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MOUNTAIN HMO NUMBER",
            "identifier": "840999425011",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, RAILROAD",
            "identifier": "P00376779",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "840999425",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.