NPIMap

Organization Active NPI

Bruce D. Carlson

  • Rural Health Clinic/Center
  • Condon, OR
National Provider Identifier
1376608901
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BRUCE D. CARLSON
Practice address
422 N Main
Condon, OR 97823-0705
Phone
(541) 384-2061
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Cindy Hess
Title
Office Manager
Phone
(541) 384-2061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

422 N Main
Condon, OR 97823-0705

Mailing address

PO Box 705
Condon, OR 97823-0705
Phone (541) 384-2061

Other identifiers 2

IdentifierTypeStateIssuer
223149MedicaidOR
DA2998OtherMEDICARE-RAILROAD

Other names 1

  • Gilliam County Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1376608901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 705",
            "city": "CONDON",
            "state": "OR",
            "postal_code": "978230705",
            "telephone_number": "541-384-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 N MAIN",
            "city": "CONDON",
            "state": "OR",
            "postal_code": "978230705",
            "telephone_number": "541-384-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE D. CARLSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "HESS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-384-2061"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223149",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-RAILROAD",
            "identifier": "DA2998",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gilliam County Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Condon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.