Bend Memorial Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BEND MEMORIAL CLINIC PC

Practice address

13000 SW Century Drive
Bend, OR 97702

Phone

(541) 706-5499

NPI assigned

Oct 14, 2011

Organization subpart

No

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

Authorized official

Name

Gregory Hagfors

Title

Ceo

Phone

(541) 706-5401

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1447535075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016051",
            "telephone_number": "541-382-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 SW CENTURY DRIVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-706-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEND MEMORIAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-14",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "HAGFORS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-706-5401"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213243",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bend Memorial Clinic PC
• Bend Memorial Clinic PC
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• Bend Memorial Clinic, PC

• Family Medicine Physician in Bend, OR
• Providers in Bend, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.