Organization Active NPI

Charles S Ross DO PC

  • Health Service Clinic/Center
  • Roseburg, OR
National Provider Identifier
1548645542
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
DO10012 Issued in OR
Legal business name
CHARLES S ROSS DO PC
Practice address
360 Loredo Dr
Roseburg, OR 97471-9235
Phone
(541) 957-9489
NPI assigned
Jul 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Charles S Ross, DO
Title
President
Phone
(541) 957-9489

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X DO10012 OR Primary

Addresses

Primary practice location

360 Loredo Dr
Roseburg, OR 97471-9235

Mailing address

360 Loredo Dr
Roseburg, OR 97471-9235
Phone (541) 957-9489

National Provider Directory

National Provider Directory

Locations

1109 NW Garden Valley Blvd
Roseburg, OR 97471
Phone (541) 680-0361

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1548645542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 LOREDO DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974719235",
            "telephone_number": "541-957-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 LOREDO DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974719235",
            "telephone_number": "541-957-9489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES S ROSS DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-957-9489",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "OR",
            "license": "DO10012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.