BD North Bend I, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH1431 Issued in WA

Legal business name

BD NORTH BEND I, LLC

Practice address

219 Cedar Ave S
North Bend, WA 98045-8262

Phone

(425) 888-2129

Fax

(425) 888-2168

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Doug Devore

Title

Cfo

Phone

(425) 392-4066

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Regency North Bend Rehabilitation and Nursing Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1225136385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 160TH AVE SE",
            "address_2": "SUITE 120",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980086418",
            "telephone_number": "425-392-4066",
            "fax_number": "425-623-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 CEDAR AVE S",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458262",
            "telephone_number": "425-888-2129",
            "fax_number": "425-888-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BD NORTH BEND I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "DEVORE",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "425-392-4066"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH1431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4111878",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114310",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency North Bend Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in North Bend, WA
• Providers in North Bend, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.