Fall Creek Internal Medicine, LLP

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FALL CREEK INTERNAL MEDICINE, LLP

Practice address

2160 NE Williamson CT
Bend, OR 97701-3760

Phone

(541) 389-1118

Fax

(541) 389-2662

NPI assigned

Feb 2, 2007

Last updated

Aug 22, 2020By 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

Ms. Nita A Hollums

Title

Office Manager

Phone

(541) 389-1118

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/FCIM/api/FHIR/R4

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathryn Marie Kocurek, M.D.

  • Internal Medicine Physician
  • Bend, OR
  • NPI 1790849131
  Medicare reassignment Care Compare group NPD
• Patricia Ann Nibler, M.D.

  • Internal Medicine Physician
  • Bend, OR
  • NPI 1386708873
  Medicare reassignment Care Compare group NPD
• Kristin M Vandomelen, M.D.

  • Internal Medicine Physician
  • Bend, OR
  • NPI 1710117122
  Medicare reassignment Care Compare group NPD
• Brittany L Perry, M.D.

  • Internal Medicine Physician
  • Lafayette, CO
  • NPI 1942434717

  OR

  Medicare reassignment Care Compare group NPD
• Jessica Jensen

  • Physician Assistant
  • Bend, OR
  • NPI 1578188777
  Medicare reassignment Care Compare group
• Monica Mattick, LCSW

  • Clinical Social Worker
  • Bend, OR
  • NPI 1902298151
  Medicare reassignment NPD
• Jennifer Aguilar

  • Community Health Worker
  • Bend, OR
  • NPI 1326902693

  Single Specialty

  NPD
• Christine Marie Pierson, MD

  • Internal Medicine Physician
  • Bend, OR
  • NPI 1013936152
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518005222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 NE WILLIAMSON CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013760",
            "telephone_number": "541-389-1118",
            "fax_number": "541-389-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 NE WILLIAMSON CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013760",
            "telephone_number": "541-389-1118",
            "fax_number": "541-389-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL CREEK INTERNAL MEDICINE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLUMS",
        "authorized_official_first_name": "NITA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-389-1118",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Fairman
• Cora Faith
• Shelly Rene Falconer, LCSW
• Tad Falk, M.S.
• Matthew Allen Falkenstein, D.D.S.
• Falling Waters LLC
• Siena Marie Falzon, QMHA
• Family Choice Urgent Care LLC (Family Choice Urgent Care)
• Dustin Alexander Fanning-Painter, QMHA
• Margaret Lynn Fanning, RPH

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

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.