Organization Active NPI

Umpqua Valley Internists PC

  • Internal Medicine Physician
  • Roseburg, OR
National Provider Identifier
1780065870
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UMPQUA VALLEY INTERNISTS PC
Practice address
1813 W Harvard Ave
Ste 423
Roseburg, OR 97471-2752
Phone
(541) 440-6323
Fax
(541) 440-6399
NPI assigned
Jun 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Angela Jones, MDNPI 1174759997
Title
President
Phone
(541) 440-6323

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1813 W Harvard Ave
Ste 423
Roseburg, OR 97471-2752

Mailing address

1813 W Harvard Ave
Ste 423
Roseburg, OR 97471-2752
Phone (541) 440-6323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150827001714 OR Part B Supplier - Clinic/Group Practice 4284940800 Receives reassigned benefits from 2 practitioners
Practice locations: Roseburg, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1780065870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE",
            "address_2": "STE 423",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712752",
            "telephone_number": "541-440-6323",
            "fax_number": "541-440-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE",
            "address_2": "STE 423",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712752",
            "telephone_number": "541-440-6323",
            "fax_number": "541-440-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMPQUA VALLEY INTERNISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-440-6323",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.