Paulina Peak Family Healthcare Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200250124NP Issued in OR

Legal business name

PAULINA PEAK FAMILY HEALTHCARE INC

Practice address

51384 Highway 97
La Pine, OR 97739-9871

Phone

(541) 536-8060

NPI assigned

Dec 11, 2006

Last updated

Oct 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory L Miller

Title

Administrator

Phone

(541) 536-8060

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1184784332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3389",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977393389",
            "telephone_number": "541-536-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51384 HIGHWAY 97",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977399871",
            "telephone_number": "541-536-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULINA PEAK FAMILY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-536-8060"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200250124NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD9066",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norco. Inc
• Northwest Dental Group, PC-Lapine
• Ronald Otto Nowack, DC
• Adaobi Okonkwo, MD
• Mallory Ann Olney, LAC, MACOM
• Paulina Peaks Family Healthcare
• Zoe Pearlman, PA-C
• Chloe Pedalino, LICSW, LCSW
• Marie C Pelzer, PT, DPT
• Leah Powers

• Family Nurse Practitioner in La Pine, OR
• Providers in La Pine, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.