NPIMap

Organization Active NPI

Deschutes County Oregon

  • State or Local Public Health Clinic/Center
  • Bend, OR
National Provider Identifier
1023056017
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
License
261QP0905X Issued in OR
Legal business name
DESCHUTES COUNTY OREGON
Practice address
2577 NE Courtney Dr
Bend, OR 97701-7638
Phone
(541) 322-7400
Fax
(541) 322-7465
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Gerard Inbody
Title
Health Services Deputy Director
Phone
(541) 322-7678

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 042981 OR
Ambulatory Family Planning Facility 261QA0005X 030805147 OR
State or Local Public Health Clinic/Center 261QP0905X 261QP0905X OR Primary

Addresses

Primary practice location

2577 NE Courtney Dr
Bend, OR 97701-7638

Mailing address

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 322-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000568 OR Part B Supplier - Clinic/Group Practice 9638083371 Receives reassigned benefits from 118 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bend, OR; Redmond, OR; Lapine, OR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Deschutes Co Mental HLT12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

63311 Jamison St
Bend, OR 97703
Phone (541) 332-7500

409 NE Greenwood Ave
Ste 2
Bend, OR 97701

Practitioners & affiliated clinicians

Practitioners 96

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 96

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507852800000",
    "number": "1023056017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017638",
            "telephone_number": "541-322-7400",
            "fax_number": "541-322-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017638",
            "telephone_number": "541-322-7400",
            "fax_number": "541-322-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESCHUTES COUNTY OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2017-10-13",
        "status": "A",
        "authorized_official_last_name": "INBODY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "HEALTH SERVICES DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "541-322-7678"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OR",
            "license": "042981",
            "primary": false
        },
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "OR",
            "license": "030805147",
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "OR",
            "license": "261QP0905X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.