NPIMap

Organization Active NPI

Gutierrez Holistic Family Medicine LLC

  • Primary Care Clinic/Center
  • Eugene, OR
National Provider Identifier
1255693313
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
DO152080 Issued in OR
Legal business name
GUTIERREZ HOLISTIC FAMILY MEDICINE LLC
Practice address
3575 Donald St
Suite 110
Eugene, OR 97405-4753
Phone
(458) 205-5907
Fax
(154) 131-9722
NPI assigned
Jun 13, 2012
Last updated
Dec 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Orestes Gutierrez, D.O.NPI 1558332791
Title
Family Physician
Phone
(541) 232-5627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X DO152080 OR Primary

Addresses

Primary practice location

3575 Donald St
Suite 110
Eugene, OR 97405-4753

Mailing address

3575 Donald St
Suite 110 a & B
Eugene, OR 97405-4753
Phone (458) 205-5907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121003000048 OR Part B Supplier - Clinic/Group Practice 8628227873 Receives reassigned benefits from 4 practitioners
Practice locations: Springfield, OR

National Provider Directory

National Provider Directory

Locations

3575 Donald St
Ste 110
Eugene, OR 97405
Phone (541) 248-4984

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21748/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1255693313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 DONALD ST",
            "address_2": "SUITE 110 A & B",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054753",
            "telephone_number": "458-205-5907",
            "fax_number": "154-131-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 DONALD ST",
            "address_2": "SUITE 110",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054753",
            "telephone_number": "458-205-5907",
            "fax_number": "154-131-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTIERREZ HOLISTIC FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "ORESTES",
        "authorized_official_title_or_position": "FAMILY PHYSICIAN",
        "authorized_official_telephone_number": "541-232-5627",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "DO152080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.