Therapeutic Associates, Inc
Organization Active NPI Physical Therapist · Sisters, OR
NPI 1942517065 · NPPES record last updated Oct 29, 2012
Key facts
- NPI
- 1942517065
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- THERAPEUTIC ASSOCIATES, INC
- Practice address
- 1011 Desperado TRL
Suite 201
Sisters, OR 97759-9580 - Phone
- (541) 549-3574
- Fax
- (541) 549-1092
- NPI assigned
- Sep 10, 2010
- Organization subpart
- No
Authorized official
- Name
- Todd Gifford
- Title
- Coo
- Phone
- (800) 219-8835
Corporate family (same tax ID) 16
Practitioners 4
-
Christopher Neal Cooper, MSPT
-
Matthew Joseph Kirchoff, P.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040205000432 | OR | Part B Supplier - Clinic/Group Practice | 0042116279 |
Receives reassigned benefits from 305 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Sally J Miller PT
Locations
1011 E Desperado Trl
Ste 201
Sisters, OR 97759
Phone (541) 549-3574
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | OR | Yes | |
| Occupational Therapist |
225X00000X | OR |
Addresses
Primary practice location
1011 Desperado TRL
Suite 201
Sisters, OR 97759-9580
Mailing address
16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500625598 | Medicaid | OR |
Other names
- TAI - Central Oregon Sisters
NPI Registry JSON
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1351468800000",
"number": "1942517065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD",
"address_2": "SUITE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "800-219-8835",
"fax_number": "503-639-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 DESPERADO TRL",
"address_2": "SUITE 201",
"city": "SISTERS",
"state": "OR",
"postal_code": "977599580",
"telephone_number": "541-549-3574",
"fax_number": "541-549-1092"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THERAPEUTIC ASSOCIATES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-09-10",
"last_updated": "2012-10-29",
"status": "A",
"authorized_official_last_name": "GIFFORD",
"authorized_official_first_name": "TODD",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "800-219-8835"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "OR",
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "OR",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500625598",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "TAI - Central Oregon Sisters",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sisters, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2012. 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.