Active NPI
Delmar Lewis Greenleaf, MD
- Family Medicine Physician
- Bend, OR
National Provider Identifier
1134213218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD17098
- Practice address
- 804 NE Third St
Bend, OR 97701 - Phone
- (541) 317-5533
- Fax
- (541) 617-2919
- NPI assigned
- Oct 3, 2006
- Last updated
- Oct 29, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD17098 | OR | Primary |
Addresses
Primary practice location
804 NE Third St
Bend, OR 97701
Mailing address
804 NE Third St
Bend, OR 97701
Phone (541) 317-5533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061705 | Medicaid | OR |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17098 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193616000000",
"number": "1134213218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 NE THIRD ST",
"city": "BEND",
"state": "OR",
"postal_code": "97701",
"telephone_number": "541-317-5533",
"fax_number": "541-617-2919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 NE THIRD ST",
"city": "BEND",
"state": "OR",
"postal_code": "97701",
"telephone_number": "541-317-5533",
"fax_number": "541-617-2919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENLEAF",
"first_name": "DELMAR",
"middle_name": "LEWIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD17098",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061705",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.