Individual provider Active NPI

Connor Perkins

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1972295715
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64917 Issued in OR
Practice address
1342 SE Medical Center Drive Ste 150
Bend, OR 97701-5951
Phone
(541) 382-7875
NPI assigned
May 22, 2023
Last updated
May 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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 64917 OR Primary

Addresses

Primary practice location

1342 SE Medical Center Drive Ste 150
Bend, OR 97701-5951

Mailing address

805 SW Industrial Way Ste 3
Bend, OR 97702-1093

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230911002162 OR Practitioner - Physical Therapist in Private Practice 5294199154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1342 NE Medical Ctr Dr
Suite 150
Bend, OR 97701-5919
Phone (541) 382-7875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Jun 28, 2023 Accepting new patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Jun 28, 2023 Accepting new patients

Locations

1303 NE Cushing Dr
Ste 150
Bend, OR 97701
Phone (541) 382-7875

805 SW Industrial Way
Ste 3
Bend, OR 97702
Phone (541) 323-5864

1717 NE 2nd St
Redmond, OR 97756
Phone (541) 332-9045

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1972295715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY STE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 SE MEDICAL CENTER DRIVE STE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977015951",
            "telephone_number": "541-382-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "CONNOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64917",
            "primary": true
        }
    ],
    "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 May 22, 2023; 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.