NPIMap

Organization Active NPI

Central Oregon Magnetic Resonance Imaging LLC

  • Diagnostic Radiology Physician
  • Redmond, OR
National Provider Identifier
1336503341
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTRAL OREGON MAGNETIC RESONANCE IMAGING LLC
Practice address
1253 NW Canal Blvd Ste 101
Redmond, OR 97756-1334
Phone
(541) 548-8131
Fax
(541) 382-2719
NPI assigned
Apr 6, 2016
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Kris Harvey
Title
Senior Vice President of Admin
Phone
(541) 598-3218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

1253 NW Canal Blvd Ste 101
Redmond, OR 97756-1334

Mailing address

PO Box 6059
Bend, OR 97708-6059
Phone (541) 382-6633

Other names 1

  • Central Oregon MRI Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171018001990 OR Part B Supplier - Clinic/Group Practice 8224058003 Receives reassigned benefits from 42 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Redmond, OR; Bend, OR

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Member of 2

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1336503341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6059",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086059",
            "telephone_number": "541-382-6633",
            "fax_number": "541-382-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD STE 101",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-548-8131",
            "fax_number": "541-382-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OREGON MAGNETIC RESONANCE IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2024-01-16",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT OF ADMIN",
        "authorized_official_telephone_number": "541-598-3218"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Oregon MRI",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Central Oregon MRI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.