Active NPI
Scott K Siebe, MD
- Internal Medicine Physician
- Enterprise, OR
National Provider Identifier
1568455822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 11894
- Practice address
- 603 Medical Parkway
Enterprise, OR 97828-1168 - Phone
- (541) 426-4502
- Fax
- (541) 426-6403
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 11894 | OR | Primary |
Addresses
Primary practice location
603 Medical Parkway
Enterprise, OR 97828-1168
Mailing address
603 Medical Parkway
Enterprise, OR 97828-1168
Phone (541) 426-4502
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| O80051456 | Other | OR | RAILROAD MEDICARE |
| J054903 | Other | OR | PACIFIC SOURCE |
| 237040 | Medicaid | OR | |
| 5966006 | Other | OR | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11894 | OR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1568455822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 MEDICAL PARKWAY",
"city": "ENTERPRISE",
"state": "OR",
"postal_code": "978281168",
"telephone_number": "541-426-4502",
"fax_number": "541-426-6403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 MEDICAL PARKWAY",
"city": "ENTERPRISE",
"state": "OR",
"postal_code": "978281168",
"telephone_number": "541-426-4502",
"fax_number": "541-426-6403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEBE",
"first_name": "SCOTT",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "11894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "O80051456",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFIC SOURCE",
"identifier": "J054903",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "237040",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5966006",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enterprise, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.