DR. JACK GILLINGHAM PT, DPT
NPI 1548090004
Physical Therapist - Orthopedic in Talent, OR

Q: What is Jack Gillingham's NPI number?

The NPI number for Jack Gillingham is 1548090004. It was assigned to this individual provider in the NPPES registry on August 7, 2024.

Q: What is Jack Gillingham's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Q: When was this NPI record last updated?

The NPPES record for Jack Gillingham was last updated on August 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since August 07, 2024

288 S PACIFIC HWY, TALENT, OR 97540(541) 482-6360 Get Directions Write a Review

NPPES record last updated: August 7, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Jack Gillingham Pt, Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK GILLINGHAM PT, DPT (NPI 1548090004) is an individual orthopedic provider in Talent, Oregon, licensed in Oregon (65317) and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1548090004

Entity TypeIndividualMale

Primary Taxonomy2251X0800X

Provider Legal NameDR. JACK GILLINGHAMCredential: PT, DPT

Location Address288 S PACIFIC HWYTalent, OR 97540-6649

Mailing Address36 Hawthorne StMedford, OR 97504-7114

Phone(541) 482-6360

Sole ProprietorNo

Enumeration DateAugust 7, 2024

NPPES CertifiedAugust 7, 2024

✔ NPI 1548090004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251X0800X

License✔ Licensed in OR · 65317

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

288 S PACIFIC HWY, Talent, OR 97540

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack Gillingham Pt, Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Jack Gillingham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jackson County Physical Therapy LLP

7.4 mi

Physical Therapist

36 HAWTHORNE ST.
Medford, OR 97504

Reassigned Medicare billing, Oregon enrollment
19 clinicians in this Medicare group

NPI 1013112903 (541) 776-2333

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANDA L LEWIS PA-C

Physician Assistant

288 S PACIFIC HWY
TALENT, OR 97540

Jackson County (304) 520-6644

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 Jack Gillingham's NPI number?

The NPI number for Jack Gillingham is 1548090004. It was assigned to this individual provider in the NPPES registry on August 7, 2024.

Where is Jack Gillingham located?

Jack Gillingham practices at 288 S Pacific Hwy, Talent, OR 97540. The listed phone number is (541) 482-6360.

What is Jack Gillingham's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Is Jack Gillingham enrolled in Medicare?

Yes. Jack Gillingham is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jack Gillingham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Gillingham reassigns Medicare benefits to Jackson County Physical Therapy LLP (Medford, OR). The 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 Jack Gillingham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jack Gillingham accept?

Health plans from Moda Health Plan, Inc. list Jack Gillingham 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 Jack Gillingham was last updated on August 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.