Medilogic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

OP60159597 Issued in WA

Legal business name

MEDILOGIC LLC

Doing business as

Restoration Medical Care

Practice address

406 SE 131St Ave
Suite 109
Vancouver, WA 98683-4004

Phone

(541) 991-1006

Fax

(360) 326-2271

NPI assigned

Aug 4, 2015

Last updated

Apr 11, 2017By 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

Mr. Jason Hill Works

Title

Administrator

Phone

(541) 991-1006

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Restoration Medical Care Doing business as

Practitioners 2

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.

• Andrea Marie Buckler, D.O.

  • Family Medicine Physician
  • Vancouver, WA
  • NPI 1376868224
  NPD (past)
• Gwyneth Theresa Jones, DNP, FNP

  • Family Nurse Practitioner
  • Vancouver, WA
  • NPI 1164576617
  NPD (past)

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1629454327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE STE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834031",
            "telephone_number": "541-991-1006",
            "fax_number": "360-326-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE",
            "address_2": "SUITE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "541-991-1006",
            "fax_number": "360-326-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDILOGIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "WORKS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "HILL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-991-1006",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "OP60159597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500634349",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Medical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Med RX Partners, P.C. (Med Rx Partners)
• Ashley Medak
• Linda R Medeski-Nicacio, OD
• Nooshin-Nikki Nikki Medghalchy, LAC
• Medicare Hearing Co
• Cinthya Isabel Medina
• Mark Anthony Medina
• Natasha Marie Medina, MED., LMHC
• Paige Alayne Medina, MSN, RN, PMHNP-BC
• Trisha Rochelle Medina

• Primary Care Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.