Individual provider Active NPI

Brian Corbett, PT

  • Physical Therapist
  • Lebanon, OR
National Provider Identifier
1851453062
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4566 Issued in OR
Practice address
1300 E Grant St Ste 100
Lebanon, OR 97355-9539
Phone
(541) 258-8222
Fax
(541) 258-8221
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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 4566 OR Primary

Addresses

Primary practice location

1300 E Grant St Ste 100
Lebanon, OR 97355-9539

Mailing address

824 W Lewis St Ste 204
Pasco, WA 99301-5561
Phone (509) 544-0265

Other identifiers 1

IdentifierTypeStateIssuer
231020MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000004 OR Practitioner - Physical Therapist in Private Practice 7416850383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Physical Therapy Inc PSGroup PAC ID 6305747643, 44 clinicians

Practice addresses (Care Compare)

1300 E Grant St
Suite 100
Lebanon, OR 97355-9539
Phone (541) 258-8222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4566ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Physical Therapy Inc PS Physical Therapist CurrentSince Mar 1, 2003 Accepting new patients
Institute of Physical Therapy and Fitness Physical Therapist Past Accepting new patients
Peak Physical Therapy P C Physical Therapist PastSince Dec 1, 2022 Accepting new patients

Locations

1300 E Grant St
Ste 100
Lebanon, OR 97355
Phone (541) 258-8222

1020 S Main St
Milton Frwtr, OR 97862
Phone (541) 938-2028

7201 W Clearwater Ave
Ste B101
Kennewick, WA 99336
Phone (509) 544-0265

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1851453062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 W LEWIS ST STE 204",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015561",
            "telephone_number": "509-544-0265",
            "fax_number": "509-544-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E GRANT ST STE 100",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973559539",
            "telephone_number": "541-258-8222",
            "fax_number": "541-258-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "BRIAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231020",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.