Ambulatory Surgery Center of Roseburg, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

07 1542 Issued in OR

Legal business name

AMBULATORY SURGERY CENTER OF ROSEBURG, LLC

Practice address

2801 NW Mercy Dr
Ste 200
Roseburg, OR 97470-2348

Phone

(541) 677-2800

Fax

(541) 677-2820

NPI assigned

Jun 16, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Vanessa T Vu, M.D., PHD

Title

Chief Operating Officer

Phone

(541) 677-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ORegon Surgery Center Doing business as

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174528038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 NW MERCY DR",
            "address_2": "STE 200",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702348",
            "telephone_number": "541-677-2800",
            "fax_number": "541-677-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NW MERCY DR",
            "address_2": "STE 200",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702348",
            "telephone_number": "541-677-2800",
            "fax_number": "541-677-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY SURGERY CENTER OF ROSEBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "541-677-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PHD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "07 1542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100343",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ORegon Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.