Coos Bay Rehabilitation, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COOS BAY REHABILITATION, INC.

Practice address

2625 Koos Bay Blvd
Coos Bay, OR 97420-4907

Phone

(541) 267-2161

NPI assigned

Jul 16, 2006

Last updated

Aug 22, 2020By the provider in NPPES

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

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700803723",
    "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": "2625 KOOS BAY BLVD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204907",
            "telephone_number": "541-267-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOS BAY REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-22",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Confederated Tribes of Coos, Lower Umpqua & Siuslaw Indians (Three Rivers Health Center - Coos Bay)
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• Bret Alan Cook, MD
• Tyler Dawn Cooper, PMHNP
• Coos Bay of Cascadia, LLC
• Coos Bay Rehabilitation, LLC (Avamere Rehabilitation of Coos Bay)
• Coos Bay School District 9
• Coos Bay Vision Center
• Coos Bay Vision Center, Inc
• Coos Clinic LLC (Coos Clinic)

• Skilled Nursing Facility in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Skilled Nursing Facility in Oregon

• 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.