Individual provider Active NPI

Camilla Beth Knackstedt, OTR/L

  • Occupational Therapist
  • Bend, OR
National Provider Identifier
1871766816
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
238531 Issued in OR
Practice address
1025 NE Purcell Blvd
Bend, OR 97701-7316
Phone
(541) 312-4300
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 238531 OR Primary
Occupational Therapist 225X00000X OT60010440 WA

Addresses

Primary practice location

1025 NE Purcell Blvd
Bend, OR 97701-7316

Mailing address

1939 Mayes Rd SE
Lacey, WA 98503-3437
Phone (206) 551-4307

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109001499 OR Practitioner - Occupational Therapist in Private Practice 6507008950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1010 NE Purcell Blvd
Bend, OR 97701-5113
Phone (541) 385-8500

1025 NE Purcell Blvd
Bend, OR 97701-7316
Phone (541) 312-4300

1165 McGee CT NE
Keizer, OR 97303-9492
Phone (503) 390-1300

17950 SW 115TH Ave
Tualatin, OR 97062-7044
Phone (503) 692-1748

20215 Powers Rd
Bend, OR 97702-3705
Phone (541) 388-9800

2205 Gilman Dr
Oregon City, OR 97045-1563
Phone (503) 657-5700

504 Gwinn St E
Monmouth, OR 97361-1571
Phone (503) 831-8331

5881 Woodside Dr SE
Salem, OR 97306-9695
Phone (503) 316-0687

621 W Oak St
Lebanon, OR 97355-1788
Phone (541) 258-7777

9000 SW 91St Ave
Tigard, OR 97223-6809
Phone (503) 445-4363

910 -960 Boone Rd SE
Salem, OR 97306-1527
Phone (503) 363-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Occupational Therapist CurrentSince Nov 15, 2024 Accepting new patients

Locations

20215 Powers Rd
Bend, OR 97702
Phone (541) 318-3322

1025 NE Purcell Blvd
Bend, OR 97701
Phone (503) 312-4300

20225 Powers Rd
Bend, OR 97702
Phone (541) 318-3322

1010 NE Purcell Blvd
Bend, OR 97701
Phone (541) 318-6042

9000 SW 91st Ave
Tigard, OR 97223
Phone (503) 445-4363

17950 SW 115th Ave
Tualatin, OR 97062
Phone (503) 692-1748

Organizations & group practices 1

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1871766816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MAYES RD SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985033437",
            "telephone_number": "206-551-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 NE PURCELL BLVD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017316",
            "telephone_number": "541-312-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNACKSTEDT",
        "first_name": "CAMILLA",
        "middle_name": "BETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "238531",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60010440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.