NPIMap

Organization Active NPI

St. Charles Health System, Inc.

Doing business as St. Charles Immediate Care Clinic

  • Family Medicine Physician
  • Bend, OR
National Provider Identifier
1144524273
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. CHARLES HEALTH SYSTEM, INC.
Doing business as
St. Charles Immediate Care Clinic
Practice address
2600 NE Neff Rd
Bend, OR 97701-6337
Phone
(541) 706-3700
Fax
(541) 706-3730
NPI assigned
Jan 4, 2011
Last updated
Jan 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Authorized official

Name
Karen M Shepard
Title
Sr VP Finance / Cfo
Phone
(541) 706-7707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2600 NE Neff Rd
Bend, OR 97701-6337

Mailing address

PO Box 1420
Redmond, OR 97756-0400
Phone (541) 526-6556

Other identifiers 1

IdentifierTypeStateIssuer
500625168MedicaidOR

Other names 1

  • ST. CHARLES IMMEDIATE CARE CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Palaniappan G Muthappan MD19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1144524273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1420",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560400",
            "telephone_number": "541-526-6556",
            "fax_number": "541-706-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016337",
            "telephone_number": "541-706-3700",
            "fax_number": "541-706-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CHARLES HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP FINANCE / CFO",
        "authorized_official_telephone_number": "541-706-7707"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500625168",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. CHARLES IMMEDIATE CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 4, 2011; 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.