NPIMap

Organization Active NPI

Eugene Pediatric Associates LLC

Doing business as Eugene Pediatric Associates

  • Pediatric Adolescent Medicine Physician
  • Eugene, OR
National Provider Identifier
1659442960
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD09583 Issued in OR
Legal business name
EUGENE PEDIATRIC ASSOCIATES LLC
Doing business as
Eugene Pediatric Associates
Practice address
995 Willagillespie Rd
Suite 100
Eugene, OR 97401-2186
Phone
(541) 484-5443
Fax
(541) 687-5621
NPI assigned
Nov 10, 2006
Last updated
Feb 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Mrs. Maryann Potter
Title
Office Manager
Phone
(541) 484-5443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MD09583 OR Primary

Addresses

Primary practice location

995 Willagillespie Rd
Suite 100
Eugene, OR 97401-2186

Mailing address

995 Willagillespie Rd
Suite 100
Eugene, OR 97401-2186
Phone (541) 484-5443

Other names 1

  • EUGENE PEDIATRIC ASSOCIATES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eugene Pediatric Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1680 Chambers St
Ste 106
Eugene, OR 97402

995 Willagillespie Rd
Eugene, OR 97401
Phone (541) 246-7263

995 Willagillespie Rd
#100
Eugene, OR 97401
Phone (541) 484-5437

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1659442960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 WILLAGILLESPIE RD",
            "address_2": "SUITE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012186",
            "telephone_number": "541-484-5443",
            "fax_number": "541-687-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 WILLAGILLESPIE RD",
            "address_2": "SUITE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012186",
            "telephone_number": "541-484-5443",
            "fax_number": "541-687-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE PEDIATRIC ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-484-5443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OR",
            "license": "MD09583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EUGENE PEDIATRIC ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.