LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. (NPI# 1982101143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982101143 |
| Entity Type | Organization |
| Organization Name | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. |
| Practice Address |
169 Ne 102nd Ave Portland OR 97220-4169 |
| Mailing Address |
218 N I St Lompoc CA 93436-0909 |
| Practice Telephone | 5034778645 |
| Mailing Telephone | 8057367887 |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2018-04-12 |
| Authorized Official Name | AMY D'AMATO (CONTRACTS MANAGER) |
| Authorized Official Telephone | 8052643388 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912460874 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 5701 21st Ave W Ste 3, Bradenton, FL 34209-5605 | 2019-04-08 |
| 1174084578 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 802 Iowa Ave, Los Banos, CA 93635-3450 | 2019-03-28 |
| 1083175483 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 777 S Ham Ln Ste G, Lodi, CA 95242-3593 | 2019-03-28 |
| 1275090870 | Lags Spine and Sportscare Medical Centers, Inc. | Social Worker | 2651 S C St Ste 200, Oxnard, CA 93033-3560 | 2019-03-01 |
| 1346707114 | Lags Spine and Sportscare Medical Centers, Inc. | Social Worker | 607 Creston Rd, Paso Robles, CA 93446-2775 | 2019-02-27 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1700357068 | Lags Spine and Sportscare Medical Centers, Inc. | Durable Medical Equipment & Medical Supplies | 3550 Q St Ste 105, Bakersfield, CA 93301-1645 | 2018-12-16 |
| 1487122339 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 11820 Ne Crestwood Dr Ste 100, Vancouver, WA 98684-5103 | 2018-11-08 |
| 1689157059 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 801 E Chapel St Ste 6, Santa Maria, CA 93454-4607 | 2018-09-12 |
| 1588147094 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 803 Coffee Rd Ste 11, Modesto, CA 95355-4244 | 2018-09-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC | 218 North I Street, Lompoc, CA 93436 |
| Washington State Corporations | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. | 11820 Ne Crestwood Dr, Vancouver, WA 98684-5102 |
| Street Address |
169 NE 102ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-4169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376632356 | Thomas Jefferson Saddoris II | Internal Medicine | 169 Ne 102nd Ave, Portland, OR 97220-4169 | 2006-10-11 |
| 1558997502 | Lags Spine and Sportscare Medical Centers, Inc. | Durable Medical Equipment & Medical Supplies | 169 Ne 102nd Ave, Portland, OR 97220-4169 | 2020-03-20 |
| 1316468127 | Lags Spine and Sportscare Medical Centers, Inc. | Counselor | 169 Ne 102nd Ave, Portland, OR 97220-4169 | 2017-06-30 |
| 1013302223 | Lags Medical Centers, Or, P.C. | Physical Medicine & Rehabilitation | 169 Ne 102nd Ave, Portland, OR 97220-4169 | 2015-04-03 |
| 1952622508 | Willamette Valley Immunology Center PC | Internal Medicine | 169 Ne 102nd Ave, Portland, OR 97220-4169 | 2010-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831598259 | Pain and Injury Medical Group Inc | Physical Medicine & Rehabilitation | 2440 Se 89th Ave, Suite 1, Portland, OR 97216-2053 | 2014-08-21 |
| 1639286867 | James Paul Kulik | Physical Medicine & Rehabilitation | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2006-08-24 |
| 1548203334 | Stephen Z Hull | Physical Medicine & Rehabilitation | 1364 Congress St, Unit 3, Portland, ME 04102-2119 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225650864 | David Edison Harris | Physical Medicine & Rehabilitation | 707 Murphy Rd Ste 101, Medford, OR 97504-8520 | 2020-05-16 |
| 1265062202 | Resurgent Health, LLC | Physical Medicine & Rehabilitation | 2850 Se Powell Valley Rd Ste 205a, Gresham, OR 97080-1489 | 2020-01-17 |
| 1568003887 | Transform Health LLC | Physical Medicine & Rehabilitation | 1200 Executive Pkwy Ste 260, Eugene, OR 97401-2199 | 2019-10-08 |
| 1215434519 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 17175 Sw Tualatin Valley Hwy Ste A-1, Beaverton, OR 97003-4584 | 2018-04-12 |
| 1275037020 | Daniel Eric Marsh Jr. | Physical Medicine & Rehabilitation | 14290 Marjorie Ln Apt 2098, Oregon City, OR 97045-7863 | 2018-03-19 |
| 1013417351 | Burnside Surgery Center LLC | Physical Medicine & Rehabilitation | 689 Nw Burnside Rd Fl 1, Gresham, OR 97030-3739 | 2018-02-13 |
| 1902117898 | Jennifer K Cann | Physical Medicine & Rehabilitation | 9400 Sw Beaverton Hillsdale Hwy Ste 205, Beaverton, OR 97005-3349 | 2010-06-25 |
| 1639303597 | Trevor Dee Jorgensen | Physical Medicine & Rehabilitation | 2003 Cedar St, Forest Grove, OR 97116-1701 | 2009-05-07 |
| 1033319124 | Gregory M Phillips | Physical Medicine & Rehabilitation | 74b Centennial Loop Ste 300, Neurospine Institute LLC, Eugene, OR 97401-7925 | 2007-07-18 |
| 1144428079 | Rebeca M Monreal | Physical Medicine & Rehabilitation | 1100 22nd St Se, Salem, OR 97302-6558 | 2007-07-03 |
| Find all providers with the same taxonomy | ||||
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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.