DR. KING SCOPE CLINIC, LLC (NPI# 1528333010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528333010 |
| Entity Type | Organization |
| Organization Name | DR. KING SCOPE CLINIC, LLC |
| Practice Address |
2699 N 17th St Coos Bay OR 97420-2134 |
| Mailing Address |
1000 Willagillespie Rd Suite 350 Eugene OR 97401-2178 |
| Practice Telephone | 5412697358 |
| Mailing Telephone | 5413430952 |
| Mailing Fax Number | 5413438034 |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |
| Authorized Official Name | DR. WILLIAM D. KING (OWNER) |
| Authorized Official Telephone | 5412697358 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD13871 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
2699 N 17TH ST |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420-2134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598758880 | Wesley J Johnson | Orthopaedic Surgery | 2699 N 17th St, Coos Bay, OR 97420-2194 | 2005-08-23 |
| 1275167462 | Pacific Cascade Pain and Anesthesia LLC | Nurse Anesthetist, Certified Registered | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2020-02-26 |
| 1548705585 | Matthew E Cornia | Physician Assistant | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2016-12-29 |
| 1093833717 | Radiology Associates, PC | Specialist | 2699 N 17th St, Coos Bay, OR 97420-2111 | 2007-03-27 |
| 1477651560 | Harry Sirounian | Orthopaedic Surgery | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2006-09-20 |
| 1376551424 | Garry T Vallier | Orthopaedic Surgery | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2006-08-04 |
| 1356388458 | Shaun M Hobson | Orthopaedic Surgery | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2006-05-31 |
| 1396792784 | Alan L Whitney | Orthopaedic Surgery | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2006-05-30 |
| 1871540252 | Jeffrey K Bert | Orthopaedic Surgery | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2006-05-30 |
| 1245284751 | South Coast Orthopaedic Associates, PC | Durable Medical Equipment & Medical Supplies | 2699 N 17th St, Coos Bay, OR 97420-2134 | 2006-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664700 | Howard Philip Grill | Internal Medicine | 1775 Thompson Rd Bay Area, Coos Bay, OR 97420-2125 | 2005-07-29 |
| 1922004365 | Andrew Rowe Maslona | Internal Medicine | 1750 Thompson Rd, Coos Bay, OR 97420 | 2005-06-21 |
| 1316344807 | Ravindra Patel | Internal Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2014-11-26 |
| 1780003525 | Ram Hanno | Internal Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2014-04-09 |
| 1386908598 | Keerti Jaini | Internal Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2012-07-02 |
| 1689968943 | Satish Jagan Mohan Bankuru | Internal Medicine | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2011-06-04 |
| 1770716144 | Prabhakar Ashokkumar Patel | Internal Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2009-09-01 |
| 1720216963 | Bhaskar Ongole | Internal Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2009-06-25 |
| 1013167303 | Bhavani Peddagovindu | Internal Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2008-09-24 |
| 1982851143 | Sushan Joshi | Internal Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2008-08-19 |
| Find all providers in COOS BAY | ||||
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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.