Organization Active NPI

Northeast Oregon Surgical Clinic

  • Surgery Physician
  • Pendleton, OR
National Provider Identifier
1053595603
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD26075 Issued in OR
Legal business name
NORTHEAST OREGON SURGICAL CLINIC
Practice address
2474 S.W. Perkins Ave
Pendleton, OR 97801
Phone
(541) 966-1001
Fax
(541) 966-1195
NPI assigned
Dec 18, 2007
Last updated
Jan 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Authorized official

Name
Mr. Andrew L Bower, M.D.NPI 1538250394
Title
General Surgeon
Phone
(541) 966-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD26075 OR Primary

Addresses

Primary practice location

2474 S.W. Perkins Ave
Pendleton, OR 97801

Mailing address

2474 S. W. Perkins Ave
Pendleton, OR 97801
Phone (541) 966-1001

National Provider Directory

National Provider Directory

Locations

1600 SE Court Pl
Ste 100
Pendleton, OR 97801
Phone (541) 966-1001

2474 SW Perkins Ave
Pendleton, OR 97801
Phone (541) 966-1001

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": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1053595603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2474 S. W. PERKINS AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "97801",
            "telephone_number": "541-966-1001",
            "fax_number": "541-966-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 S.W. PERKINS AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "97801",
            "telephone_number": "541-966-1001",
            "fax_number": "541-966-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OREGON SURGICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "BOWER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "GENERAL SURGEON",
        "authorized_official_telephone_number": "541-966-1001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD26075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.