Organization Active NPI

Mountain Medical Group LLC

  • Urgent Care Clinic/Center
  • Bend, OR
National Provider Identifier
1104962067
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MOUNTAIN MEDICAL GROUP LLC
Practice address
1302 NE 3Rd St
Bend, OR 97701-4333
Phone
(541) 388-7799
Fax
(541) 389-4096
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Albert James Stone, MD
Title
Owner
Phone
(541) 317-0909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1302 NE 3Rd St
Bend, OR 97701-4333

Mailing address

1302 NE 3Rd St
Bend, OR 97701-4333
Phone (541) 388-7799

National Provider Directory

National Provider Directory

Locations

1302 NE 3rd St
Bend, OR 97701
Phone (541) 385-6388

1245 SE 3rd St
Ste C3
Bend, OR 97702
Phone (541) 385-6388

198 NE Combs Flat Rd
Ste 110
Prineville, OR 97754
Phone (541) 362-8688

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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1104962067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 NE 3RD ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014333",
            "telephone_number": "541-388-7799",
            "fax_number": "541-389-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 NE 3RD ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014333",
            "telephone_number": "541-388-7799",
            "fax_number": "541-389-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-317-0909",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 4, 2007; 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.