Active NPI
Bianca Deris
- Specialist
- Florence, OR
National Provider Identifier
1124486741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 04-03-13
- Practice address
- 1015 Prestwick CT
Florence, OR 97439-9585 - Phone
- (541) 574-9570
- Fax
- (541) 574-8857
- NPI assigned
- Feb 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 04-03-13 | OR | Primary |
Addresses
Primary practice location
1015 Prestwick CT
Florence, OR 97439-9585
Mailing address
1015 Prestwick CT
Florence, OR 97439-9585
Phone (541) 574-9570
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455062400000",
"number": "1124486741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 PRESTWICK CT",
"city": "FLORENCE",
"state": "OR",
"postal_code": "974399585",
"telephone_number": "541-574-9570",
"fax_number": "541-574-8857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 PRESTWICK CT",
"city": "FLORENCE",
"state": "OR",
"postal_code": "974399585",
"telephone_number": "541-574-9570",
"fax_number": "541-574-8857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERIS",
"first_name": "BIANCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-10",
"last_updated": "2016-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "04-03-13",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.