Active NPI
FM Ocean Ridge, LLC
Doing business as Ocean Ridge Assisted Living
- Assisted Living Facility
- Coos Bay, OR
National Provider Identifier
1053937680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- FM OCEAN RIDGE, LLC
- Doing business as
- Ocean Ridge Assisted Living
- Practice address
- 1855 Ocean Blvd SE
Coos Bay, OR 97420-1940 - Phone
- (541) 267-4000
- Fax
- (541) 267-4411
- NPI assigned
- Jun 19, 2020
- Last updated
- Jun 19, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gregory Roderick
- Title
- Member
- Phone
- (503) 443-1818
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
1855 Ocean Blvd SE
Coos Bay, OR 97420-1940
Mailing address
7420 SW Bridgeport Rd Ste 105
Portland, OR 97224-7790
Phone (503) 597-4906
Other names 1
- Ocean Ridge Assisted Living
National Provider Directory
National Provider DirectoryLocations
7420 SW Bridgeport Rd
Ste 105
Portland, OR 97224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1592524800000",
"number": "1053937680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7420 SW BRIDGEPORT RD STE 105",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972247790",
"telephone_number": "503-597-4906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1855 OCEAN BLVD SE",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974201940",
"telephone_number": "541-267-4000",
"fax_number": "541-267-4411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FM OCEAN RIDGE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-06-19",
"last_updated": "2020-06-19",
"certification_date": "2020-06-19",
"status": "A",
"authorized_official_last_name": "RODERICK",
"authorized_official_first_name": "GREGORY",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "503-443-1818"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Ocean Ridge Assisted Living",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.