Grants Pass Imaging and Diagnotic Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GRANTS PASS IMAGING AND DIAGNOTIC CENTER, LLC

Practice address

1619 NW Hawthorne Ave Ste 204
Grants Pass, OR 97526-6009

Phone

(541) 472-5154

Fax

(541) 472-5178

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David Clague Oehling, MD

Title

Medical Director

Phone

(541) 472-5154

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659307973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 NW HAWTHORNE AVE STE 204",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975266009",
            "telephone_number": "541-472-5154",
            "fax_number": "541-472-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 NW HAWTHORNE AVE STE 204",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975266009",
            "telephone_number": "541-472-5154",
            "fax_number": "541-472-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANTS PASS IMAGING AND DIAGNOTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "OEHLING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CLAGUE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "541-472-5154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170137",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.