NPIMap

Organization Active NPI

St. Charles Health System, Inc.

  • Internal Medicine Physician
  • Bend, OR
National Provider Identifier
1295974491
Registry record updated Dec 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST. CHARLES HEALTH SYSTEM, INC.
Practice address
2100 NE Wyatt CT
Suite 103
Bend, OR 97701-7702
Phone
(541) 706-4701
Fax
(541) 706-4751
NPI assigned
Feb 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2010

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

Authorized official

Name
Karen M Shepard
Title
Sr VP Finance / Cfo
Phone
(541) 706-7707

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2100 NE Wyatt CT
Suite 103
Bend, OR 97701-7702

Mailing address

PO Box 1420
Redmond, OR 97756-0400
Phone (541) 526-6556

Other identifiers 1

IdentifierTypeStateIssuer
500625168MedicaidOR

Other names 1

  • ST. CHARLES CANCER CENTER - BEND Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cascade Healthcare Community19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2100 NE Wyatt Ct
Ste 103
Bend, OR 97701
Phone (541) 317-9555

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293148800000",
    "number": "1295974491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1420",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560400",
            "telephone_number": "541-526-6556",
            "fax_number": "541-706-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE WYATT CT",
            "address_2": "SUITE 103",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017702",
            "telephone_number": "541-706-4701",
            "fax_number": "541-706-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CHARLES HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2010-12-24",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP FINANCE / CFO",
        "authorized_official_telephone_number": "541-706-7707"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500625168",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. CHARLES CANCER CENTER - BEND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 24, 2010; 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.