CENTRAL OREGON DERMATOLOGY, PC (NPI# 1336307875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336307875 |
| Entity Type | Organization |
| Organization Name | CENTRAL OREGON DERMATOLOGY, PC |
| Practice Address |
388 Sw Bluff Dr Bend OR 97702-1360 |
| Practice Telephone | 5416780020 |
| Practice Fax Number | 5413832174 |
| Mailing Telephone | 5416780020 |
| Mailing Fax Number | 5413832174 |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2011-12-01 |
| Authorized Official Name | JODI HANEY (OFFICE MANAGER) |
| Authorized Official Telephone | 5413232181 |
| Authorized Official Credential | RHIT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | MD26648 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NPI (INDIVIDUAL) | 1609815166 | 01 |
| OR | DEA | BH9058125 | 01 |
| OR | LICENSE | MD26648 | 01 |
| OR | 241835 | 05 |
| Street Address |
388 SW BLUFF DR |
| City | BEND |
| State | OR |
| Zip Code | 97702-1360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609815166 | Mark A Hall | Dermatology | 388 Sw Bluff Dr, Bend, OR 97702-1360 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811408537 | Erika Beard-irvine, Md, LLC | Clinic/Center | 403 Ne Revere Avenue, Bend, OR 97701-4018 | 2017-10-20 |
| 1982089207 | Dr. Jeff Mcnown Chiropractic, P.C. | Clinic/Center | 141 Nw Greenwood Ave Ste 101, Bend, OR 97701-2041 | 2015-07-28 |
| 1306262795 | Cascade Cancer Care LLC | Clinic/Center | 25 Nw Louisiana Ave Ste 100, Bend, OR 97701-3294 | 2014-03-11 |
| 1285964304 | Virtual Nurse Practitioner LLC | Clinic/Center | 2654 Ne Jill Ct, Bend, OR 97701-5887 | 2010-01-12 |
| 1073756615 | Adam Derr, P.C. | Clinic/Center | 528 Ne Greenwood Ave, Bend, OR 97701-4611 | 2009-04-13 |
| 1942852165 | Bend Natural Health | Clinic/Center | 2955 N Highway 97, Bend, OR 97703-7559 | 2019-07-09 |
| 1659835106 | Ideal Option, Pllc | Clinic/Center | 404 Ne Penn Ave, Bend, OR 97701-4264 | 2019-01-29 |
| 1356848352 | Omhc, LLC | Clinic/Center | 595 Sw Bluff Dr Ste A, Bend, OR 97702-1283 | 2018-04-07 |
| 1265940308 | Monarch Medical Group LLC | Clinic/Center | 595 Sw Bluff Dr Ste A, Bend, OR 97702-1283 | 2018-01-10 |
| 1952811408 | Plasker Chiropractic and Functional Neurology LLC | Clinic/Center | 155 Sw Century Dr Ste 104, Bend, OR 97702-1657 | 2017-10-10 |
| Find all providers in BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.