Organization Active NPI

Umpqua Internal Medicine,P.C.

  • Medical Specialty Clinic/Center
  • Roseburg, OR
National Provider Identifier
1053576868
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MD24774 Issued in OR
Legal business name
UMPQUA INTERNAL MEDICINE,P.C.
Practice address
2510 NW Edenbower Blvd
Suite 176
Roseburg, OR 97471-8899
Phone
(541) 673-2254
NPI assigned
Jul 21, 2008
Last updated
May 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Rodica Totoian
Title
Manager
Phone
(541) 378-8461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MD24774 OR Primary

Addresses

Primary practice location

2510 NW Edenbower Blvd
Suite 176
Roseburg, OR 97471-8899

Mailing address

2510 NW Edenbower Blvd
Suite 176
Roseburg, OR 97471-8899
Phone (541) 673-2254

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080819000243 OR Part B Supplier - Clinic/Group Practice 4284709700 Receives reassigned benefits from 1 practitioner
Practice locations: Roseburg, OR

National Provider Directory

National Provider Directory

Locations

2510 NW Edenbower Blvd
Ste 17
Roseburg, OR 97471

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADEJBD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1053576868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 NW EDENBOWER BLVD",
            "address_2": "SUITE 176",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718899",
            "telephone_number": "541-673-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 NW EDENBOWER BLVD",
            "address_2": "SUITE 176",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718899",
            "telephone_number": "541-673-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMPQUA INTERNAL MEDICINE,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "TOTOIAN",
        "authorized_official_first_name": "RODICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "541-378-8461"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "MD24774",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 2, 2013; 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.