GLENN M KOTEEN M.D., LLC (NPI# 1407021348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407021348 |
| Entity Type | Organization |
| Organization Name | GLENN M KOTEEN M.D., LLC |
| Other Organization Name | GASTROENTEROLOGY OF CENTRAL OREGON |
| Practice Address |
2450 Ne Mary Rose Pl Ste 210 Bend OR 97701-7132 |
| Practice Telephone | 5417280535 |
| Practice Fax Number | 5416475125 |
| Mailing Telephone | 5417280535 |
| Mailing Fax Number | 5416475125 |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-11-14 |
| Authorized Official Name | DR. GLENN M KOTEEN (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 5417280535 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD25338 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 022737 | 05 | |
| OR | MEDICARE # | 120175 | 01 |
| Other Name | Type Code |
|---|---|
| Gastroenterology of Central Oregon | Doing Business As Name - Organization |
| Street Address |
2450 NE MARY ROSE PL STE 210 |
| City | BEND |
| State | OR |
| Zip Code | 97701-7132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295730158 | Peter Edward Palacio | Obstetrics & Gynecology | 2450 Ne Mary Rose Pl, Suite 220, Bend, OR 97701-7132 | 2005-06-16 |
| 1639614951 | Invmd Plastic Surgery LLC | Plastic Surgery | 2450 Ne Mary Rose Pl, Ste 200, Bend, OR 97701-7132 | 2016-12-21 |
| 1356782908 | John A. Murphy Md PC | Obstetrics & Gynecology | 2450 Ne Mary Rose Pl, #220, Bend, OR 97701-7132 | 2013-07-11 |
| 1083054373 | Peter E. Palacio, M.d., PC | Obstetrics & Gynecology | 2450 Ne Mary Rose Pl, Suite 220, Bend, OR 97701-7132 | 2013-07-01 |
| 1093010985 | Andrew P Higgins Md-surgeon LLC | Surgery | 2450 Ne Mary Rose Pl, Suite 205, Bend, OR 97701-7132 | 2011-01-24 |
| 1912154089 | Jacqueline D Lebrun | Audiologist-Hearing Aid Fitter | 2450 Ne Mary Rose Pl, Ste 120, Bend, OR 97701-7132 | 2008-08-20 |
| 1457524985 | Emilie M Hart-hutter | Audiologist | 2450 Ne Mary Rose Pl, 120, Bend, OR 97701-7132 | 2008-04-04 |
| 1750590238 | Justin D Hill | Otolaryngology | 2450 Ne Mary Rose Pl, Bend, OR 97701-7132 | 2007-05-22 |
| 1770797060 | Ida Alul | Ophthalmology | 2450 Ne Mary Rose Pl, Suite 110, Bend, OR 97701-7132 | 2007-05-09 |
| 1528271707 | Patricia O Buehler | Ophthalmology | 2450 Ne Mary Rose Pl, Suite 110, Bend, OR 97701 | 2007-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026466 | Kyle D. Homertgen Bend Osteopathic Care PC | Clinic/Center | 147 Sw Shevlin Hixon Dr Ste 204, Bend, OR 97702-1137 | 2020-09-02 |
| 1417316191 | Ronald Guiley Od, Mph, PC | Clinic/Center | 63455 N Hwy 97, Ste 75, Bend, OR 97703 | 2016-02-23 |
| 1356745301 | Deschutes Health LLC | Clinic/Center | 612 Ne Savannah Dr, Suite 1, Bend, OR 97701-4874 | 2014-10-20 |
| 1720331994 | Wendy Weintrob Inc | Clinic/Center | 701 Nw Arizona Ave, Suite 200, Bend, OR 97701-3298 | 2012-10-24 |
| 1467951962 | Active Motion Chiropractic | Clinic/Center | 2955 N Hwy 97, Bend, OR 97703-7559 | 2018-02-09 |
| 1295274520 | Pure Light Family Chiropractic, LLC | Clinic/Center | 155 Sw Century Dr, Bend Pilates, Bend, OR 97702-1657 | 2017-02-20 |
| 1043653777 | Gary D Buchholz Md PC | Clinic/Center | 2275 Ne Doctors Dr, Suite 9, Bend, OR 97701-6324 | 2013-04-11 |
| 1174868020 | Bend Osteopathic Care, PC | Clinic/Center | 147 Sw Shevlin Hixon Dr, Suite 204, Bend, OR 97702-3130 | 2012-12-04 |
| 1073886412 | Lifetime Vision Care LLC | Clinic/Center | 901 Nw Carlon Ave, Suite 2, Bend, OR 97703-2636 | 2012-02-15 |
| 1477655264 | All Womens Care P C | Clinic/Center | 25 Nw Louisiana Ave, Ste 100, Bend, OR 97701-3203 | 2006-09-02 |
| 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.