Southwest Physical Therapy LLC
Organization Active NPI Rehabilitation Clinic/Center · Coos Bay, OR
NPI 1851407464 · NPPES record last updated Sep 24, 2007
Key facts
- NPI
- 1851407464
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Clinic/Center 261QR0400X
- Legal business name
- SOUTHWEST PHYSICAL THERAPY LLC
- Practice address
- 1650 Thompson Rd
Coos Bay, OR 97420-2170 - Phone
- (541) 269-7212
- Fax
- (541) 267-5260
- NPI assigned
- Aug 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. John Breuer, PT
- Title
- Director
- Phone
- (541) 269-7212
Corporate family (same tax ID) 5
Practitioners 24
-
Gregory Carter Amador, P.T.
-
John Bain, PT
-
Glenda Gay Balneg, P.T.
-
John Breuer, PT
-
Kathryn Creer, PT
-
Nicolette Fonseca, PT, DPT
-
Sharon Hogan, OTRL
-
Yuriko I Hori, PHYSICAL THERAPIST
-
Paula Hunt, PHYSICAL THERAPIST
-
Christine Burton Hyatt Boyd, PHYSICAL THERAPIST
-
Robert Carl Mach, PHYSICAL THERAPIST
-
Damon Stephen Massey, P.T.
-
Eric Mohrbacher, OT
-
Ashley Mortensen, DPT
-
Paul Edward Smith, PT, DPT
-
John Soukup, PT, MTC
-
Emilio Aranda, DPT
-
Denise E Boyd, PT
-
Caroline Grace Cantera, PT, DPT
-
Kathryn E Ralston, P.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050810001218 | OR | Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 9133111362 | Practice locations: Bandon, OR; Coos Bay, OR; Coquille, OR; Gold Beach, OR |
National Provider Directory
- Tax ID family
- John Breuer Rehab Services
Locations
565 5th St
Ste 1
Brookings, OR 97415
Phone (541) 469-0969
279 N Central Blvd
Coquille, OR 97423
Phone (541) 396-3341
2285 Highway 101
Ste F
Florence, OR 97439
Phone (541) 902-0231
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | Yes |
Addresses
Primary practice location
1650 Thompson Rd
Coos Bay, OR 97420-2170
Mailing address
1650 Thompson Rd
Coos Bay, OR 97420-2170
Phone (541) 269-7212
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207027 | Medicaid | OR |
Other names
- John Breuer Rehab Services
Other providers in Coos Bay, OR
- South Coast Hospice & Palliative Care Services Inc
- South Coast Orthopaedic Associates, PC
- South Coast Radiologists
- South Coast Surgery Center, LLC
- Southwest Physical Therapy LLC
- Rayshal Lee Spalding
- Sparrow Audiology LLC
- Spectrum Orthotics & Prosthetics Inc
- Spectrum Prosthetics LLC
- Alex Michael Spencer
All providers in Coos Bay, OR · Rehabilitation Clinic/Center in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.