DOCTORS PARK SURGERY CENTER, LLC (NPI# 1417906660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417906660 |
| Entity Type | Organization |
| Organization Name | DOCTORS PARK SURGERY CENTER, LLC |
| Practice Address |
2090 Ne Wyatt Ct Suite 102 Bend OR 97701-7687 |
| Mailing Address |
20 Burton Hills Blvd Suite 500 Attn: L&c Nashville TN 37215-6197 |
| Practice Telephone | 5413895931 |
| Practice Fax Number | 5413895932 |
| Mailing Telephone | 6152403820 |
| Mailing Fax Number | 6152341720 |
| Enumeration Date | 2006-05-07 |
| Last Update Date | 2013-04-17 |
| Authorized Official Name | PHILLIP A CLENDENIN (PRESIDENT OF LLC) |
| Authorized Official Telephone | 6156651283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | DOCTORS PARK SURGERY CENTER, LLC | 1a Burton Hills Blvd, Nashville, TN 37215 |
| Street Address |
2090 NE WYATT CT SUITE 102 |
| City | BEND |
| State | OR |
| Zip Code | 97701-7687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962464271 | Nora Vanessa Takla | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-03 |
| 1104217744 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 2090 Ne Wyatt Ct, Ste 201, Bend, OR 97701-7687 | 2015-02-17 |
| 1730355488 | Michelle L Fitts | Physician Assistant | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2008-05-02 |
| 1316161680 | Meredith Rae Baker | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2007-04-11 |
| 1992838866 | Frank Cobarrubia Dpmpc | Podiatrist | 2090 Ne Wyatt Ct, Ste. 201, Bend, OR 97701-7687 | 2007-03-13 |
| 1124078738 | William J Corrigan | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-12 |
| 1831149079 | Timothy Krigbaum | Physician Assistant | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-10 |
| 1508815754 | Bend Urology Associates, LLC | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-07 |
| 1629030523 | Brian Timothy O'hollaren | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-05 |
| 1518929439 | Jack Alan Brewer | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-05 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457826125 | Central Oregon Surgical Institute, LLC | Clinic/Center | 1550 Ne 27th St Ste 110, Bend, OR 97701-7728 | 2018-10-09 |
| 1760861835 | Central Oregon Surgery Center LLC | Clinic/Center | 1835 Nw Pence Ln Ste 100, Bend, OR 97703-1551 | 2015-05-22 |
| 1477949766 | Deschutes Surgery Center, LLC | Clinic/Center | 2115 Ne Wyatt Ct, Suite 105, Bend, OR 97701-7678 | 2015-04-13 |
| 1346545589 | Central Oregon Surgery Center | Clinic/Center | 2400 Ne Neff Rd, Suite B, Bend, OR 97701-6752 | 2011-01-19 |
| 1174551758 | Asc Gi Diagnostic Center, LLC | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2006-06-30 |
| 1376536482 | Bend Surgery Center LLC | Clinic/Center | 1303 Ne Cushing Dr, Suite 200, Bend, OR 97701-3887 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1962920751 | West End Surgical, LLC | Clinic/Center | 9405 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-09-01 |
| 1588181275 | Chase Gardens Surgery Center LLC | Clinic/Center | 360 S Garden Way Ste 100, Eugene, OR 97401-8173 | 2017-08-24 |
| 1164946984 | Northwest Renal Clinic, Inc. | Clinic/Center | 9701 Sw Barnes Rd Ste 110, Portland, OR 97225-6774 | 2017-08-02 |
| 1679939318 | Crater Lake Surgery Center LLC | Clinic/Center | 833 Bennett Ave, Medford, OR 97504-6715 | 2016-01-11 |
| 1902287469 | Gateway Dental Surgery Center | Clinic/Center | 10535 Ne Glisan St Ste 101, Portland, OR 97220-4095 | 2015-06-10 |
| 1972902286 | Oregon Specialists Surgery Center LLC | Clinic/Center | 2785 River Rd S, Salem, OR 97302-5883 | 2014-08-22 |
| 1649612698 | Willamette Procedure Center PC | Clinic/Center | 2020 8th Ave Ste 212, West Linn, OR 97068-4657 | 2013-07-18 |
| 1780959007 | Columbia River Surgery Center LLC | Clinic/Center | 9820 Ne Cascades Pkwy, Portland, OR 97220-6825 | 2012-03-20 |
| 1487933172 | Mt. Scott Surgery Center, LLC | Clinic/Center | 9300 Se 91st Ave Ste 101, Clackamas, OR 97086-3762 | 2011-08-11 |
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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.