NPIMap

Organization Active NPI

Central Oregon Magnetic Resonance Imaging LLC

  • Diagnostic Radiology Physician
  • Bend, OR
National Provider Identifier
1194596304
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTRAL OREGON MAGNETIC RESONANCE IMAGING LLC
Practice address
1693 SW Chandler Ave Ste 140
Bend, OR 97702-3230
Phone
(541) 388-0673
NPI assigned
Jan 16, 2024
Last updated
Jun 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Kristine Anne Harvey
Title
Associate Administrator
Phone
(541) 598-3218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1693 SW Chandler Ave Ste 140
Bend, OR 97702-3230

Mailing address

PO Box 6059
Bend, OR 97708-6059
Phone (541) 382-6633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171018001990 OR Part B Supplier - Clinic/Group Practice 8224058003 Receives reassigned benefits from 42 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Redmond, OR; Bend, OR

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Central Oregon Magnetic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1693 SW Chandler Ave
Ste 101
Bend, OR 97702

2500 NE Neff Rd
#1
Bend, OR 97701

2500 NE Neff Rd
Ste LL1
Bend, OR 97701
Phone (541) 241-1540

1253 NW Canal Blvd
#101
Redmond, OR 97756

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1194596304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6059",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086059",
            "telephone_number": "541-382-6633",
            "fax_number": "541-383-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 SW CHANDLER AVE STE 140",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023230",
            "telephone_number": "541-388-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OREGON MAGNETIC RESONANCE IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "ASSOCIATE ADMINISTRATOR",
        "authorized_official_telephone_number": "541-598-3218"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.