Autonomic Innovations, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

AUTONOMIC INNOVATIONS, LLC

Practice address

6464 SW Borland Rd
Ste C3
Tualatin, OR 97062-8876

Phone

(971) 252-6411

Fax

(971) 252-6412

NPI assigned

Jan 8, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Robert Richard Johansen

Title

Coo

Phone

(503) 780-9221

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1669838470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD",
            "address_2": "STE C3",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628876",
            "telephone_number": "971-252-6411",
            "fax_number": "971-252-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD",
            "address_2": "STE C3",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628876",
            "telephone_number": "971-252-6411",
            "fax_number": "971-252-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTONOMIC INNOVATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "503-780-9221",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.