FM Aspen MC, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FM ASPEN MC, LLC

Practice address

1025 NE Purcell Blvd
Bend, OR 97701-7316

Phone

(503) 312-4300

Fax

(503) 312-6674

NPI assigned

Jun 18, 2020

Organization subpart

No

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

Authorized official

Name

Gregory A. Roderick

Title

Member

Phone

(503) 443-1818

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Aspen Ridge Memory Care Doing business as

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1750907473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 SW BRIDGEPORT RD STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247790",
            "telephone_number": "503-597-4906",
            "fax_number": "503-443-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 NE PURCELL BLVD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017316",
            "telephone_number": "503-312-4300",
            "fax_number": "503-312-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FM ASPEN MC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-443-1818"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "524331",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Ridge Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Flow Weight Loss
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• Shannon Bird Flowerday
• Kelly Leigh Flynn, MS, LPCA
• FM Aspen Ret, LLC
• Focus Physical Therapy, Inc.
• Daniel E Fohrman, M.D.
• Adam Foley
• Devin Foley

• Assisted Living Facility in Bend, OR
• Providers in Bend, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.