Active NPI
Paul B Bascom MD
- Internal Medicine Physician
- Gold Beach, OR
National Provider Identifier
1720407463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD16983
- Legal business name
- PAUL B BASCOM MD
- Practice address
- 94220 4TH St
Gold Beach, OR 97444-7756 - Phone
- (503) 961-2017
- NPI assigned
- Apr 9, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul B Bascom, M.D.
- Title
- Owner
- Phone
- (503) 961-2017
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD16983 | OR | Primary |
Addresses
Primary practice location
94220 4TH St
Gold Beach, OR 97444-7756
Mailing address
3439 NE Sandy Blvd
Mailbox 601
Portland, OR 97232-1959
Phone (503) 961-2017
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397001600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1397001600000",
"number": "1720407463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3439 NE SANDY BLVD",
"address_2": "MAILBOX 601",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321959",
"telephone_number": "503-961-2017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94220 4TH ST",
"city": "GOLD BEACH",
"state": "OR",
"postal_code": "974447756",
"telephone_number": "503-961-2017"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAUL B BASCOM MD",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-09",
"last_updated": "2014-04-09",
"status": "A",
"authorized_official_last_name": "BASCOM",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "503-961-2017",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD16983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gold Beach, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.