Bend Urology Associates, LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

BEND UROLOGY ASSOCIATES, LLC

Practice address

2090 NE Wyatt CT
Suite 101
Bend, OR 97701-7687

Phone

(541) 382-6447

Fax

(541) 330-7413

NPI assigned

May 7, 2006

Organization subpart

No

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

Authorized official

Name

Angela Gene Jordan

Title

Administrator

Phone

(541) 382-6447

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1146960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508815754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 NE WYATT CT",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017687",
            "telephone_number": "541-382-6447",
            "fax_number": "541-330-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 NE WYATT CT",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017687",
            "telephone_number": "541-382-6447",
            "fax_number": "541-330-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEND UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-382-6447"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.