Oregon TLC, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD22132 Issued in OR

Legal business name

OREGON TLC, LLC

Practice address

132 E Broadway
Suite 716
Eugene, OR 97401-3143

Phone

(817) 284-9850

Fax

(817) 284-3505

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Roy M. Blackburn, M.D.

Title

President

Phone

(817) 284-9850

Specialties & licenses 1

Addresses

Tax ID family

Oregon TLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Oregon TLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Eugene, OR
  • NPI 1174871552
  NPD tax ID

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043373434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY",
            "address_2": "SUITE 716",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013143",
            "telephone_number": "817-284-9850",
            "fax_number": "817-284-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY",
            "address_2": "SUITE 716",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013143",
            "telephone_number": "817-284-9850",
            "fax_number": "817-284-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON TLC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-284-9850",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "MD22132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oregon Spine & Physical Therapy
• Oregon Spine & Physical Therapy
• Oregon Spine and Physical Therapy
• Oregon Therapy Collective, LLC
• Oregon TLC
• Oregon Trusted Local Care Clinic
• Oregon University System
• Oregon University System
• Oregon University System
• Evangeline Oriakhi

• Physical Medicine & Rehabilitation Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Physical Medicine & Rehabilitation Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.