Organization Active NPI

Neurology of Bend LLC

  • Neurology Physician
  • Bend, OR
National Provider Identifier
1649314253
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGY OF BEND LLC
Practice address
2421 NE Doctors Dr
Bend, OR 97701-6031
Phone
(541) 388-3311
Fax
(541) 389-1887
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Dr. Gary David Buchholz, MD
Title
Member
Phone
(541) 388-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

2421 NE Doctors Dr
Bend, OR 97701-6031

Mailing address

2421 NE Doctors Dr
Bend, OR 97701-6031
Phone (541) 388-3311

Other identifiers 1

IdentifierTypeStateIssuer
213485MedicaidOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1649314253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 NE DOCTORS DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016031",
            "telephone_number": "541-388-3311",
            "fax_number": "541-389-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 NE DOCTORS DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016031",
            "telephone_number": "541-388-3311",
            "fax_number": "541-389-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY OF BEND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "BUCHHOLZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "541-388-3311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213485",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.