DIRECT PHYSICAL THERAPY, LLC
NPI 1205109014
Physical Therapist in Shady Cove, OR
About Direct Physical Therapy, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIRECT PHYSICAL THERAPY, LLC (NPI 1205109014) is a healthcare organization registered as a physical therapist in Shady Cove, Oregon and active in the NPI registry since February 2012. The organization lists Lance D Cooper, Owner/physical Therapist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Direct Physical Therapy, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Direct Physical Therapy, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Direct Physical Therapy, LLC's NPI number?
The NPI number for Direct Physical Therapy, LLC is 1205109014. It was assigned to this organization in the NPPES registry on February 10, 2012.
Where is Direct Physical Therapy, LLC located?
Direct Physical Therapy, LLC is located at 21850 Highway 62 Ste 203, Shady Cove, OR 97539. The listed phone number is (541) 941-5170.
What is Direct Physical Therapy, LLC's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Direct Physical Therapy, LLC enrolled in Medicare?
Yes. Direct Physical Therapy, LLC is registered in the Medicare PECOS enrollment system.
When is Direct Physical Therapy, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oregon, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Direct Physical Therapy, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Direct Physical Therapy, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Direct Physical Therapy, LLC accept?
Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Direct Physical Therapy, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Direct Physical Therapy, LLC was last updated on April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Direct Physical Therapy, Llc · NPI 1205109014
Physical Therapist organization in Shady Cove, Oregon. Organization record, active in the CMS NPPES registry since February 10, 2012.
## Identity
- **NPI:** 1205109014 (Entity type: Organization)
- **Enumerated:** February 10, 2012
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **Organization subpart:** No
- **Authorized official:** Lance Cooper, OWNER/PHYSICAL THERAPIST
## Practice location
- **Address:** 21850 HIGHWAY 62 STE 203, Shady Cove, OR 97539-8715
- **Phone:** (541) 941-5170 · **Fax:** (541) 878-8111
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Oregon, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Physical Therapist in Private Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1205109014) · Data from the CMS NPPES public registry.