Leading Edge Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

LEADING EDGE PHYSICAL THERAPY

Practice address

1100 Liberty St SE Ste 100
Salem, OR 97302-5385

Phone

(503) 500-5727

Fax

(971) 273-2706

NPI assigned

Nov 17, 2022

Organization subpart

No

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

Authorized official

Name

Matthew Hennings, DPTNPI 1841503422

Title

Owner

Phone

(503) 500-5727

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.

• Matthew Bradley Hennings, PT, DPT

  • Physical Therapist
  • Salem, OR
  • NPI 1841503422
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1982313995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5477 BELLFLOWER ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973061648",
            "telephone_number": "503-500-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LIBERTY ST SE STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025385",
            "telephone_number": "503-500-5727",
            "fax_number": "971-273-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADING EDGE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "HENNINGS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-500-5727",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Trinh Le
• Linda Le
• Tam Le, MOT
• Thanh Quoc Le, RPH
• John Daniel Leach, QMHP
• William Lear, MD
• Ashley Leard
• Matthew John Leary, DO
• Rebecca D Leary
• Madeline O Leavell

• Physical Therapy Clinic/Center in Salem, OR
• Providers in Salem, 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 Oct 6, 2023; 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.