| Mr Shelley Dale Johnston, RPT | |
|
301 4th St, La Grande, OR 97850-1901 | |
| (541) 963-9340 | |
| (541) 963-4562 |
| Full Name | Mr Shelley Dale Johnston |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 50 Years |
| Location | 301 4th St, La Grande, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578513917 | NPI | - | NPPES |
| 838502000 | Other | OR | RBCBSO |
| 152140 | Medicaid | OR | |
| P00233908 | Other | OR | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 0557 (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Select Rehabilitation Llc | 9032020490 | 1538 |
| Provider Name | Select Rehabilitation Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1346368248 PECOS PAC ID: 9032020490 Enrollment ID: O20230922002056 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Shelley Dale Johnston, RPT 301 4th St, La Grande, OR 97850-1901 Ph: (541) 963-9340 | Mr Shelley Dale Johnston, RPT 301 4th St, La Grande, OR 97850-1901 Ph: (541) 963-9340 |
Joanna Hallam, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2519 Cove Ave, La Grande, OR 97850 Phone: 541-962-0830 | |
James Arthur Gorham, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2519 Cove Ave, La Grande, OR 97850 Phone: 541-962-0830 Fax: 541-975-2720 | |
Julia Rae Richard, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 610 Sunset Dr, La Grande, OR 97850 Phone: 541-963-1437 | |
Mr. James Russell Hottal, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2519 Cove Ave, La Grande, OR 97850 Phone: 541-962-0830 | |
Mr. Benjamin Michael Bertrand, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 4th St, La Grande, OR 97850 Phone: 541-963-9340 Fax: 541-962-4562 | |
Jennifer Sloop Moore, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 610 Sunset Dr, La Grande, OR 97850 Phone: 541-963-1437 | |
Jefferson K Whinery, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 610 Sunset Dr, La Grande, OR 97850 Phone: 541-963-1437 |