Individual provider Active NPI

Gregg S Densmore, M.D.

  • Orthopaedic Surgery Physician
  • La Grande, OR
National Provider Identifier
1184624975
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD18510 Issued in OR
Practice address
700 Sunset Dr
Ste F
La Grande, OR 97850-1260
Phone
(541) 963-8578
Fax
(541) 963-8932
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD18510 OR Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

700 Sunset Dr
Ste F
La Grande, OR 97850-1260

Mailing address

700 Sunset Dr
Ste F
La Grande, OR 97850-1260
Phone (541) 963-8578

Other identifiers 2

IdentifierTypeStateIssuer
057724MedicaidOR
057724OtherWADEPT LABOR & INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100629000736 OR Practitioner - Orthopedic Surgery 3870624299 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 9, 2012 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 9, 2012 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1184624975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SUNSET DR",
            "address_2": "STE F",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501260",
            "telephone_number": "541-963-8578",
            "fax_number": "541-963-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SUNSET DR",
            "address_2": "STE F",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501260",
            "telephone_number": "541-963-8578",
            "fax_number": "541-963-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENSMORE",
        "first_name": "GREGG",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD18510",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057724",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT LABOR & INDUSTRIES",
            "identifier": "057724",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.