Bend Memorial Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BEND MEMORIAL CLINIC PC

Practice address

1080 Mount Bachelor Dr
Bend, OR 97702-3280

Phone

(541) 550-4400

NPI assigned

Jun 3, 2009

Organization subpart

No

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

Authorized official

Name

Gregory Hagfors

Title

Ceo

Phone

(541) 706-5401

Specialties & licenses 6

Addresses

Tax ID family

Bend Memorial Clinic PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Bend Memorial Clinic PC

  • Dermatology Physician
  • Bend, OR
  • NPI 1780846501
  NPD tax ID
• Bend Memorial Clinic PC

  • Family Medicine Physician
  • Sisters, OR
  • NPI 1851616692
  NPD tax ID
• Bend Memorial Clinic, PC

  dba Summit Health Physician Dispensary

  • Non-Pharmacy Dispensing Site
  • Bend, OR
  • NPI 1144090119
  NPD tax ID

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1689800773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016051",
            "telephone_number": "541-382-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 MOUNT BACHELOR DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023280",
            "telephone_number": "541-550-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEND MEMORIAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "HAGFORS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-706-5401"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bend Kids Pediatrics, LLC
• Bend Lapine School District
• Bend Life Acupuncture & Integrative Medicine LLC
• Bend Memorial Clinic LLP
• Bend Memorial Clinic PC
• Bend Memorial Clinic PC (Summit Health)
• Bend Memorial Clinic PC
• Bend Memorial Clinic PC (Bend Memorial Clinic PC dba Summit Health)
• Bend Memorial Clinic, PC (Summit Health Physician Dispensary)
• Bend Memory Care, LLC (Mt. Bachelor Memory Care)

• Family Medicine Physician in Bend, OR
• Providers in Bend, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.