NPIMap

Organization Active NPI

Retina & Vitreous Center of Southern Oregon, PC

  • Ophthalmology Physician
  • Ashland, OR
National Provider Identifier
1295725448
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA & VITREOUS CENTER OF SOUTHERN OREGON, PC
Practice address
246 Catalina Dr
Suite 1
Ashland, OR 97520-1624
Phone
(541) 488-3192
Fax
(541) 488-0646
NPI assigned
Oct 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Authorized official

Name
William S Rodden, MD
Title
President
Phone
(541) 488-3192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

246 Catalina Dr
Suite 1
Ashland, OR 97520-1624

Mailing address

246 Catalina Dr
Suite 1
Ashland, OR 97520-1624
Phone (541) 488-3192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040803001576 OR Part B Supplier - Clinic/Group Practice 5193796191 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ashland, OR

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

246 Catalina Dr
Ashland, OR 97520
Phone (541) 488-3192

3516 Excel Dr
Medford, OR 97504
Phone (541) 488-3192

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1295725448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 CATALINA DR",
            "address_2": "SUITE 1",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201624",
            "telephone_number": "541-488-3192",
            "fax_number": "541-488-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 CATALINA DR",
            "address_2": "SUITE 1",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201624",
            "telephone_number": "541-488-3192",
            "fax_number": "541-488-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA & VITREOUS CENTER OF SOUTHERN OREGON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "RODDEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-488-3192",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.