Roseburg Heart Associates PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD12356 Issued in OR

Legal business name

ROSEBURG HEART ASSOCIATES PC

Practice address

2700 NW Stewart Pkwy
Suite 200
Roseburg, OR 97470-1281

Phone

(541) 677-6521

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Frederic J Van Dis, MDNPI 1093786261

Title

President

Phone

(541) 677-6521

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Frederic J Van Dis, MD

  • Cardiovascular Disease Physician
  • Roseburg, OR
  • NPI 1093786261
  NPD (past) Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1730308529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "address_2": "SUITE 200",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701281",
            "telephone_number": "541-677-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "address_2": "SUITE 200",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701281",
            "telephone_number": "541-677-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEBURG HEART ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "VAN DIS",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-677-6521",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD12356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roseburg Counseling & Wellness
• Roseburg Douglas Associates
• Roseburg Family Dental Care
• Roseburg Family Medicine
• Roseburg Foot & Ankle Specialists, P.C.
• Roseburg Massage Health & Beauty Spa, LLC
• Roseburg Oncology PC
• Roseburg Radiologists P C
• Roseburg Therapy LLC
• Roseburg Therapy LLC

• Cardiovascular Disease Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Cardiovascular Disease Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.