Full Circle Ventures, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA00844 Issued in OR

Legal business name

FULL CIRCLE VENTURES, LLC

Practice address

62806 Baskin CT
Bend, OR 97701-9565

Phone

(541) 390-2464

NPI assigned

Jul 19, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Eric S Davis, PA

Title

Owner

Phone

(541) 390-2464

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1285922641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62806 BASKIN CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019565",
            "telephone_number": "541-390-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62806 BASKIN CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019565",
            "telephone_number": "541-390-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-390-2464",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA00844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Frost-Briley
• Aurora F Fry, PT
• Delaney Frye
• Robin H Fuerst, PHARMD
• Doreen Fulk, CADC-R, QMHP-R
• Ami Simpson Fuller
• David Allen Fuller, D.M.D.
• Brian Fulmer
• Lindsay Haut Fulmer
• Funner Dentalworks LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.