Genesis Newberg Operation Co., LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GENESIS NEWBERG OPERATION CO., LLC

Doing business as

Avamere at Newberg

Practice address

730 Foothills Dr
Newberg, OR 97132-6004

Phone

(503) 554-0767

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

K. Rickard Miller Jr.

Title

Manager

Phone

(503) 570-3405

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Avamere at Newberg Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1659398469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "SUITE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 FOOTHILLS DR",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326004",
            "telephone_number": "503-554-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS NEWBERG OPERATION CO., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "K. RICKARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-570-3405",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505092",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avamere at Newberg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Branden Garland, D.C., C.C.S.P.
• Daniel Garris
• Jenna Gaskin
• Kim Gary Gauntt, D.P.M.
• Alina Geller, DO
• George Fox University
• George Fox University
• George Fox University Physical Therapy Community Clinic
• Samantha George, MD, DIPABLM
• Kathryn Giebenhain

• Assisted Living Facility in Newberg, OR
• Providers in Newberg, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.