NPIMap

Organization Active NPI

Laurence M Sharp DO PC

  • Family Medicine Physician
  • Roseburg, OR
National Provider Identifier
1033304126
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO15192 Issued in OR
Legal business name
LAURENCE M SHARP DO PC
Practice address
1813 W Harvard Ave
Suite 426
Roseburg, OR 97471-2752
Phone
(541) 459-1611
Fax
(541) 459-5741
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Dr. Laurence M Sharp, DO
Title
President
Phone
(541) 459-1611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X DO15192 OR Primary

Addresses

Primary practice location

1813 W Harvard Ave
Suite 426
Roseburg, OR 97471-2752

Mailing address

1813 W Harvard Ave
Suite 426
Roseburg, OR 97471-2752
Phone (541) 459-1611

Other identifiers 1

IdentifierTypeStateIssuer
150144MedicaidOR

National Provider Directory

National Provider Directory

Locations

1813 W Harvard Ave
Ste 426
Roseburg, OR 97471
Phone (541) 229-1611

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1033304126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE",
            "address_2": "SUITE 426",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712752",
            "telephone_number": "541-459-1611",
            "fax_number": "541-459-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE",
            "address_2": "SUITE 426",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712752",
            "telephone_number": "541-459-1611",
            "fax_number": "541-459-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURENCE M SHARP DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-459-1611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO15192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150144",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.