CMS-1500 Box 24J / 33a • NPI
1528268588
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
2251X0800X (CMS 65)
Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist, Orthopedic
Box 32 Service Location & ZIP+4
1215 SE 8TH AVE., SUITE D, PORTLAND, OR, 97214
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1528268588 (360 DEGREE SPORTS MEDICINE & SPINE THERAPY LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1528268588 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 360 DEGREE SPORTS MEDICINE & SPINE THERAPY LLC |
| Plain-English Specialty | Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist, Orthopedic NUCC Code: 2251X0800X (Physical Therapist, Orthopedic) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1215 SE 8TH AVE., SUITE D, PORTLAND, OR, 97214 |
| Practice Telephone / Fax | Tel: (503) 248-0360 | Fax: (503) 334-3675 |
| Administrative Mailing Address | 1215 SE 8TH AVE., PORTLAND, OR, 97214 |
| Enumeration & Last Sync | Enumerated: 2007-07-18 | CMS Record Updated: 2022-10-31 |
| Authorized Official | MICHELLE COFFMAN (CEO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (2251X0800X)
What Does Taxonomy Code 2251X0800X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2251X0800X translates to:
"Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist, Orthopedic"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (360 DEGREE SPORTS MEDICINE & SPINE THERAPY LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
261QP2000X — Clinic/Center, Physical TherapyPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: OR | License: 3018 | Primary: Secondary |
2251X0800X — Physical Therapist, OrthopedicPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist, Orthopedic | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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