Organization Active NPI

Pacific Coast Primary Care

  • Family Nurse Practitioner
  • Coos Bay, OR
National Provider Identifier
1114688066
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PACIFIC COAST PRIMARY CARE
Practice address
320 Central Ave Ste 304
Coos Bay, OR 97420-2241
Phone
(720) 427-5713
NPI assigned
Jan 4, 2022
Last updated
Jun 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Authorized official

Name
Douglas Miller
Title
Office Manager
Phone
(541) 269-0800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

320 Central Ave Ste 304
Coos Bay, OR 97420-2241

Mailing address

320 Central Ave Ste 304
Coos Bay, OR 97420-2241
Phone (541) 269-0800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1114688066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 304",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241",
            "telephone_number": "541-269-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 304",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241",
            "telephone_number": "720-427-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-269-0800"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 29, 2022; 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.