NPIMap

Organization Active NPI

Cardiothoracic Surgeon, PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Bend, OR
National Provider Identifier
1699706408
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
CARDIOTHORACIC SURGEON, PC
Practice address
2705 NE Conners Ave
#100
Bend, OR 97701-6904
Phone
(541) 388-1636
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John D Blizzard, MDNPI 1497775498
Title
Employee
Phone
(541) 388-1636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

2705 NE Conners Ave
#100
Bend, OR 97701-6904

Mailing address

2705 NE Conners Ave
#100
Bend, OR 97701-6904

National Provider Directory

National Provider Directory

Locations

2705 NE Conners Ave
Ste 100
Bend, OR 97701

2705 NE Conners Ave
Ste A
Bend, OR 97701

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699706408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 NE CONNERS AVE",
            "address_2": "#100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 NE CONNERS AVE",
            "address_2": "#100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016904",
            "telephone_number": "541-388-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOTHORACIC SURGEON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLIZZARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "541-388-1636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.