Omscor LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

OMSCOR LLC

Practice address

3162 State St
Medford, OR 97504-8450

Phone

(541) 779-7799

Fax

(541) 779-7805

NPI assigned

Jul 17, 2020

Organization subpart

No

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

Authorized official

Name

Lynda Stallings

Title

Insurance Manager

Phone

(541) 842-7053

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1467060293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3162 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-779-7799",
            "fax_number": "541-779-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3162 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-779-7799",
            "fax_number": "541-779-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMSCOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "STALLINGS",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "541-842-7053"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500623112",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendall Lee Olson-Cassidy
• Donald M Olson, M.D.
• Karryn Danielle Olson
• Kevan Joyce Olson, NP PSYCHIATRIC
• Erin Frances Oltman
• Oncology of Southern Oregon LLC
• One of a Kind Therapy LLC
• Onepeak Southern Oregon PC
• Ontrack, Inc.
• Jack Opgenorth, L.C.S.W.

• All providers in Medford, OR
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.