CONVERGENCE PHYSICAL THERAPY AND PERFORMANCE (NPI# 1184221335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184221335 |
| Entity Type | Organization |
| Organization Name | CONVERGENCE PHYSICAL THERAPY AND PERFORMANCE |
| Practice Address |
303 S 5th St Ste 140 Springfield OR 97477-5480 |
| Mailing Address |
224 W 37th Ave Eugene OR 97405-3312 |
| Practice Telephone | 5416250191 |
| Mailing Telephone | 8083920058 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | TYLER TANAKA (OWNER, PHYSICAL THERAPIST) |
| Authorized Official Telephone | 8083920058 |
| Authorized Official Credential | PT, DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CONVERGENCE PHYSICAL THERAPY AND PERFORMANCE, LLC | 224 W 37th Ave, Eugene, OR 97405 |
| Street Address |
303 S 5TH ST STE 140 |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97477-5480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
| 1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
| 1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
| 1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
| 1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
| 1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
| Find all providers in zip 97477 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275146474 | Beyond Recovery Physical Therapy, LLC | Clinic/Center | 2627 E Horning St, Springfield, MO 65802-2372 | 2020-08-26 |
| 1538786272 | Neurologic Optimal Wellness Physical Therapy LLC | Clinic/Center | 180 King St, Springfield, MA 01109-4316 | 2020-06-29 |
| 1154948933 | My Pt and Pilates Inc | Clinic/Center | 6706 Red Jacket Rd, Springfield, VA 22152-2633 | 2020-06-29 |
| 1043836588 | Martin Ventures LLC | Clinic/Center | 3119 S Scenic Ave Ste B, Springfield, MO 65807-3965 | 2020-06-21 |
| 1871129338 | Five Star Rehabilitation and Wellness Services LLC | Clinic/Center | 900 E Southwind Rd, Springfield, IL 62703-5369 | 2020-03-17 |
| 1992262554 | Agilitas Usa, Inc | Clinic/Center | 3556 Tom Austin Hwy Ste 2, Springfield, TN 37172-3960 | 2019-03-01 |
| 1336656461 | Back and Body Pain Relief LLC | Clinic/Center | 355 Route 22 Ste D, Springfield, NJ 07081-3511 | 2018-01-10 |
| 1699142828 | Alissa Slater | Clinic/Center | 7912 Journey Ln, Springfield, VA 22153-2725 | 2015-08-24 |
| 1801189121 | Physiotherapy Associates Inc | Clinic/Center | 1739 Allen St, Springfield, MA 01118-1805 | 2011-05-19 |
| 1912208414 | Flexeon Rehabilitation Springfield Ohio, LLC | Clinic/Center | 1303 West 1st Street, Springfield, OH 45504 | 2010-11-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97477 |
Please comment or provide details below to improve the information on CONVERGENCE PHYSICAL THERAPY AND PERFORMANCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.