Oregon Endoscopy Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

071536 Issued in OR

Legal business name

OREGON ENDOSCOPY CENTER, LLC

Practice address

3355 Riverbend Dr
Suite 510
Springfield, OR 97477-8800

Phone

(541) 868-9555

Fax

(541) 868-9556

NPI assigned

Jun 28, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Gonenne, MDNPI 1649299538

Title

Medical Director/Physician Partner

Phone

(541) 868-9555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Oregon Endoscopy Center LLCCCN 38C0001044

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Jonathan Gonenne, MD

  • Gastroenterology Physician
  • Springfield, OR
  • NPI 1649299538
  NPD Authorized official
• Peter S Kay, MD

  • Gastroenterology Physician
  • Springfield, OR
  • NPI 1710906177
  NPD
• Theresa Williams

  • Administrator Registered Nurse
  • Springfield, OR
  • NPI 1801744925
  NPD
• Shane J Mills, MD

  • Gastroenterology Physician
  • Springfield, OR
  • NPI 1699747055
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1366449910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR",
            "address_2": "SUITE 510",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-868-9555",
            "fax_number": "541-868-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR",
            "address_2": "SUITE 510",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-868-9555",
            "fax_number": "541-868-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "GONENNE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PHYSICIAN PARTNER",
        "authorized_official_telephone_number": "541-868-9555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "071536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000186",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oregon CVS Pharmacy LLC
• Oregon Dermatology & Surgery, LLC
• Oregon Directions, LLC
• Oregon Directions, LLC
• Oregon Emdr LLC
• Oregon Family Eye Care LLC
• Oregon Healthcare Resources LLC
• Oregon Healthcare Resources, LLC
• Oregon Imaging Center
• Oregon Medical Group at Thurston Physical Therapy

• Ambulatory Surgical Clinic/Center in Springfield, OR
• Providers in Springfield, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.