Columbia Gorge Neurology Specialists, LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

COLUMBIA GORGE NEUROLOGY SPECIALISTS, LLC

Practice address

1615 E 12TH St
Suite 100
The Dalles, OR 97058-3278

Phone

(541) 296-1100

Fax

(541) 236-0606

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Laurie Miller, RHIT, CCS-P

Title

Clinic Manager

Phone

(541) 296-1100

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7616/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1174729917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 E 12TH ST",
            "address_2": "SUITE 100",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583278",
            "telephone_number": "541-296-1100",
            "fax_number": "541-236-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 E 12TH ST",
            "address_2": "SUITE 100",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583278",
            "telephone_number": "541-296-1100",
            "fax_number": "541-236-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA GORGE NEUROLOGY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "541-296-1100",
        "authorized_official_credential": "RHIT, CCS-P"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Columbia Gorge Anesthesia LLC
• Columbia Gorge Education Service District
• Columbia Gorge Education Service District
• Columbia Gorge ENT, LLC
• Columbia Gorge Hearing Care LLC
• Columbia Gorge Pathology Associates, LLP
• Columbia Gorge Radiology PC
• Columbia Gorge Surgery Center, LLC
• Columbia River Eye Clinic LLC
• Columbia River Medical Clinic, P.C.

• Neurology Physician in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Neurology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.

Verify at the official NPI Registry.