NPIMap

Organization Active NPI

Oregon Coast Spine Institute, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Coos Bay, OR
National Provider Identifier
1629098157
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
MD21855 Issued in OR
Legal business name
OREGON COAST SPINE INSTITUTE, LLC
Practice address
1957 Thompson Rd
Coos Bay, OR 97420-2040
Phone
(541) 267-4429
Fax
(541) 267-5470
NPI assigned
Jul 20, 2006
Last updated
Oct 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Dara Parvin, M.D.NPI 1497774566
Title
President
Phone
(541) 267-4429

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X MD21855 OR Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X MD26085 OR

Addresses

Primary practice location

1957 Thompson Rd
Coos Bay, OR 97420-2040

Mailing address

1957 Thompson Rd
Coos Bay, OR 97420-2040
Phone (541) 267-4429

Other identifiers 2

IdentifierTypeStateIssuer
CJ7856OtherORRAILROAD MEDICARE
022841MedicaidOR

National Provider Directory

National Provider Directory

Locations

1705 Ocean Blvd SE
Ste B
Coos Bay, OR 97420
Phone (541) 267-4429

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1629098157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-267-4429",
            "fax_number": "541-267-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-267-4429",
            "fax_number": "541-267-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON COAST SPINE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "PARVIN",
        "authorized_official_first_name": "DARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-267-4429",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OR",
            "license": "MD21855",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "OR",
            "license": "MD26085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ7856",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022841",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.