Bandon Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD27591 Issued in OR

Legal business name

BANDON FAMILY MEDICINE, LLC

Practice address

475 Elmira Ave SE Ste 201
Bandon, OR 97411-7409

Phone

(541) 329-1362

Fax

(541) 329-1364

NPI assigned

Sep 27, 2007

Last updated

Jul 9, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Megan Marie Holland, M.D.

Title

Sole Member

Phone

(541) 329-1362

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1124215736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ELMIRA AVE SE STE 201",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974117409",
            "telephone_number": "541-329-1362",
            "fax_number": "541-329-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 ELMIRA AVE SE STE 201",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974117409",
            "telephone_number": "541-329-1362",
            "fax_number": "541-329-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANDON FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "541-329-1362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD27591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244093",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Marie Allison, LPC
• Mary Nell Anker, N.P.
• Bandon Chiropractic
• Bandon Coastal Dental, LLC
• Bandon Community Health Center
• Bandon Pharmacy
• Bandon Senior Living LLC (Pacific View Senior Living LLC)
• Janet M Bates, M.D.
• Kenneth Robert Bates, MD
• Rosemary Winifred Bean

• Family Medicine Physician in Bandon, OR
• Providers in Bandon, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.