Connected Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5148 Issued in OR

Legal business name

CONNECTED PHYSICAL THERAPY

Practice address

2627 Siskiyou Blvd Ste 102
Medford, OR 97504-8188

Phone

(541) 500-1779

Fax

(541) 500-1943

NPI assigned

Oct 27, 2015

Organization subpart

No

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

Authorized official

Name

Kelly Catherine Martin, PTNPI 1174687263

Title

Owner

Phone

(541) 500-1779

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

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

• Kelly Catherine Martin, PT

  • Physical Therapist
  • Medford, OR
  • NPI 1174687263
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1942672142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 SISKIYOU BLVD STE 102",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048188",
            "telephone_number": "541-500-1779",
            "fax_number": "541-500-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 SISKIYOU BLVD STE 102",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048188",
            "telephone_number": "541-500-1779",
            "fax_number": "541-500-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTED PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-500-1779",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "5148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anton Conklin, D.M.D.
• Julie A Conley-Rucker
• Jasmin Lionne Conley, MSW, LCSW
• Mary Alyse Conley, LMT
• Kathleen Marie Connair-Rau, PEER SUPPORT SPEC
• Heather Kathleen Connell
• Caroline L Connelly, FNP
• John Liam Connelly, NCC
• Denise Conner, RN
• Shara Ann Conner

• Physical Therapy Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.