NPIMap

Organization Active NPI

Juniper Ridge Developmental and Behavioral Pediatrics, LLC

  • Non-Pharmacy Dispensing Site
  • Bend, OR
National Provider Identifier
1053757666
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
JUNIPER RIDGE DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS, LLC
Practice address
62930 O B Riley Rd Ste 300
Bend, OR 97703-9459
Phone
(541) 323-5515
NPI assigned
May 22, 2013
Organization subpart
Yes
Parent organization
JUNIPER RIDGE DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Authorized official

Name
Deborah P. Coehlo, NPNPI 1922180777
Title
Medical Director
Phone
(541) 323-5515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

62930 O B Riley Rd Ste 300
Bend, OR 97703-9459

Mailing address

2980 N Beverly Glen Cir
Suite 100
Los Angeles, CA 90077-1726
Phone (310) 474-9809

Other names 1

  • Juniper Pediatrics Doing business as

National Provider Directory

National Provider Directory
Part of
Juniper Ridge Developmental and Behavioral Pediatrics LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1053757666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809",
            "fax_number": "888-431-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62930 O B RILEY RD STE 300",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977039459",
            "telephone_number": "541-323-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNIPER RIDGE DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JUNIPER RIDGE DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS, LLC",
        "enumeration_date": "2013-05-22",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "COEHLO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "541-323-5515",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Juniper Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Juniper Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 9, 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.