Sunriver Service District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

T509774 Issued in OR

Legal business name

SUNRIVER SERVICE DISTRICT

Practice address

57475 Abbot Dr
Sunriver, OR 97707-4108

Phone

(541) 593-8622

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Rod Bjorvik

Title

Fire Chief

Phone

(541) 593-8622

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1154535946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2108",
            "city": "SUNRIVER",
            "state": "OR",
            "postal_code": "977074108",
            "telephone_number": "541-593-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57475 ABBOT DR",
            "city": "SUNRIVER",
            "state": "OR",
            "postal_code": "977074108",
            "telephone_number": "541-593-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRIVER SERVICE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "BJORVIK",
        "authorized_official_first_name": "ROD",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "541-593-8622"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OR",
            "license": "T509774",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OR",
            "license": "E224737",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006474",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "122804",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS EDI",
            "identifier": "206476",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Schweitzer, D.M.D.
• Daniel Mark Skotte Sr., DO
• Gail Deann Smith, PT
• James Philip Smith, LPC
• Sunriver Pharmacy
• Mercedes Dawn Taylor, LMT
• Therapeutic Associates Inc
• Livia M Vanloo, MSPT
• Eric D Walberg, PT
• Cari Nicole Welch, LPC

• All providers in Sunriver, OR
• Land Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.