Individual provider Active NPI

Arlan George Zastrow, M. D.

  • Adult Medicine Physician
  • Roseburg, OR
National Provider Identifier
1114928058
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
MD11889 Issued in OR
Practice address
320 NW Medical Loop
Roseburg, OR 97471-1645
Phone
(541) 673-0968
Fax
(541) 673-0080
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X MD11889 OR Primary

Addresses

Primary practice location

320 NW Medical Loop
Roseburg, OR 97471-1645

Mailing address

320 NW Medical Loop
Roseburg, OR 97471-1645
Phone (541) 673-0968

Other identifiers 1

IdentifierTypeStateIssuer
217539MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas Medical Group, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1114928058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-673-0968",
            "fax_number": "541-673-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-673-0968",
            "fax_number": "541-673-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZASTROW",
        "first_name": "ARLAN",
        "middle_name": "GEORGE",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OR",
            "license": "MD11889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217539",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.