Organization Active NPI

Lung Clinic Center for Sleep Medicine

  • Pulmonary Disease Physician
  • Grants Pass, OR
National Provider Identifier
1114019494
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD16808 Issued in OR
Legal business name
LUNG CLINIC CENTER FOR SLEEP MEDICINE
Practice address
874 NE 7TH St
Grants Pass, OR 97526-1635
Phone
(541) 471-6026
Fax
(541) 471-7051
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Authorized official

Name
Debra A Stringfield
Title
Office Billing Manager
Phone
(541) 471-6026

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X MD16808 OR
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X MD16808 OR Primary
Registered Respiratory TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 227900000X RTP000581 OR
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA00609 OR

Addresses

Primary practice location

874 NE 7TH St
Grants Pass, OR 97526-1635

Mailing address

874 NE 7TH St
Grants Pass, OR 97526-1635
Phone (541) 471-6026

Other identifiers 1

IdentifierTypeStateIssuer
009576MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051116000424 OR Part B Supplier - Clinic/Group Practice 6406875723 Receives reassigned benefits from 1 practitioner
Practice locations: Grants Pass, OR

National Provider Directory

National Provider Directory

Locations

874 NE 7th St
Grants Pass, OR 97526
Phone (541) 471-6026

Interoperability endpoints

  • Direct secure messaging: carlosmarchini@lccsm.allscriptsdirect.net
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10359860

Practitioners & affiliated clinicians

Practitioners 2

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1114019494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261635",
            "telephone_number": "541-471-6026",
            "fax_number": "541-471-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261635",
            "telephone_number": "541-471-6026",
            "fax_number": "541-471-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNG CLINIC CENTER FOR SLEEP MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "STRINGFIELD",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE BILLING MANAGER",
        "authorized_official_telephone_number": "541-471-6026"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD16808",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD16808",
            "primary": true
        },
        {
            "code": "227900000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Registered",
            "state": "OR",
            "license": "RTP000581",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00609",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009576",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.