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Physician Compare National (NPI:1457760134)

HEALTHCARE PROVIDER: LEAH JOHNSTON D.P.T.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1457760134
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0547488603
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20140902002082
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name RYBOLT
Individual professional last name
Provider First Name LEAH
Individual professional first name
Provider Middle Name MARIE
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2014
Individual professional's medical school graduation year
Primary Specialty PHYSICAL THERAPY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name ENDURANCE PHYSICAL THERAPY, INC.
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 6305061029
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 5
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 4730 VILLAGE PLAZA LOOP
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 145
Group Practice or individual's line 2 address
City EUGENE
Group Practice or individual's city
State OR
Group Practice or individual's state
Zip Code 974016679
Group Practice or individual's zip code (9 digits when available)
Phone Number 5416540802
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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