Courtney Anne Roach, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA194379 Issued in OR

Practice address

2200 NE Neff Rd Ste 200
Bend, OR 97701-4281

Phone

(541) 382-3344

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: croach838413@direct.multicare.org
• Direct secure messaging: croach19388@thecenter.gardenplotortho.direct-ci.com

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment NPD
• Bend Memorial Clinic PC

  dba Summit Health

  • Family Medicine Physician
  • Bend, OR
  • NPI 1699827477
  Medicare reassignment
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment
• Bend Memorial Clinic PC

  dba Bend Memorial Clinic PC dba Summit Health

  • Clinical Medical Laboratory
  • Bend, OR
  • NPI 1972144913
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1326093873

  Physician Assistant

  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Silverton Health

  dba Legacy Woodburn Health Center

  • Rural Health Clinic/Center
  • Woodburn, OR
  • NPI 1679686463
  NPD (past)
• Multicare Health System

  dba Auburn MultiCare Clinic

  • Family Medicine Physician
  • Auburn, WA
  • NPI 1013969195

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1194296327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N GRAHAM ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271682",
            "telephone_number": "503-413-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE NEFF RD STE 200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014281",
            "telephone_number": "541-382-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 N Graham St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271682",
            "country_code": "US",
            "telephone_number": "503-413-4488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 NE Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016051",
            "country_code": "US",
            "telephone_number": "541-706-2495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROACH",
        "first_name": "COURTNEY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA194379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverbend Wellness, LLC (RiverBend Wellness)
• Rivers and Roads Counseling
• Riverside Family Counseling, LLC
• Sara Rizzo, QMHA
• Charlie Roach, LAC
• Kaia Roast
• Rob M Kassan M D LLC
• Aubrey Brewer Robbins
• Barrie Robbins, LMT, CTP (TRAGER)
• Kathleen Robbins, LPC

• Physician Assistant in Bend, OR
• Providers in Bend, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.