Bright Eyes Midwifery and Wild Rivers Womens Health,LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

200950160NP Issued in OR

Legal business name

BRIGHT EYES MIDWIFERY AND WILD RIVERS WOMENS HEALTH,LLC

Practice address

29135 Ellensburg Ave
Gold Beach, OR 97444-8722

Phone

(541) 260-5762

NPI assigned

Feb 27, 2014

Last updated

Feb 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathleen Weber Dougherty

Title

Office Manager

Phone

(541) 260-5762

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1386069326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974441710",
            "telephone_number": "541-260-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29135 ELLENSBURG AVE",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974448722",
            "telephone_number": "541-260-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT EYES MIDWIFERY AND WILD RIVERS WOMENS HEALTH,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "WEBER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-260-5762"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "200950160NP",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "000031286N5",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Gold Beach, OR
• Providers in Gold Beach, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.