Organization Active NPI

Delia Smith Physical Therapy PC

  • Occupational Therapist
  • Medford, OR
National Provider Identifier
1902113459
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
DELIA SMITH PHYSICAL THERAPY PC
Practice address
24 Myrtle St
Medford, OR 97504-7338
Phone
(541) 621-9373
Fax
(866) 746-1959
NPI assigned
Sep 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Melissa Y Arakelian, OTR/LNPI 1376746347
Title
Owner
Phone
(541) 621-9373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 3776 OR
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

24 Myrtle St
Medford, OR 97504-7338

Mailing address

PO Box 3333
Ashland, OR 97520-0312
Phone (541) 621-9373

Other practice location 1

810 E Jackson St
Medford, OR 97504-6773
Phone (541) 621-9373

Other identifiers 1

IdentifierTypeStateIssuer
6444350001OtherORPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101014000889 OR DME Supplier - Independently-Practicing Occupational Therapist 1254523830 Practice locations: Medford, OR
O20110228000171 OR Part B Supplier - Clinic/Group Practice 1254523830 Receives reassigned benefits from 1 practitioner
Practice locations: Medford, OR

National Provider Directory

National Provider Directory

Locations

14795 SW Murray Scholls Dr
Ste 121
Beaverton, OR 97007
Phone (503) 597-5647

24 Myrtle St
Medford, OR 97504
Phone (541) 621-9373

810 E Jackson St
Ste 100
Medford, OR 97504
Phone (541) 621-9373

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1902113459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3333",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975200312",
            "telephone_number": "541-621-9373",
            "fax_number": "866-746-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047338",
            "telephone_number": "541-621-9373",
            "fax_number": "866-746-1959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 E Jackson St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046773",
            "country_code": "US",
            "telephone_number": "541-621-9373",
            "fax_number": "866-746-1959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DELIA SMITH PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-04",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "ARAKELIAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-621-9373",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3776",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6444350001",
            "state": "OR"
        }
    ],
    "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 Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.