NPIMap

Organization Active NPI

Trillium Waterbirth Center

  • Birthing Clinic/Center
  • Medford, OR
National Provider Identifier
1811284409
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Birthing Clinic/CenterTaxonomy code 261QB0400X
License
07-1611 Issued in OR
Legal business name
TRILLIUM WATERBIRTH CENTER
Practice address
400 Crater Lake Ave
Medford, OR 97504-6808
Phone
(541) 772-2291
Fax
(541) 245-0417
NPI assigned
Jul 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Augustine Colebrook, CPM
Title
Owner
Phone
(541) 772-2291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Birthing Clinic/Center 261QB0400X 07-1611 OR Primary

Addresses

Primary practice location

400 Crater Lake Ave
Medford, OR 97504-6808

Mailing address

400 Crater Lake Ave
Medford, OR 97504-6808
Phone (541) 772-2291

National Provider Directory

National Provider Directory
Tax ID family
Trillium Waterbirth Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1811284409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046808",
            "telephone_number": "541-772-2291",
            "fax_number": "541-245-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046808",
            "telephone_number": "541-772-2291",
            "fax_number": "541-245-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM WATERBIRTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "COLEBROOK",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-772-2291",
        "authorized_official_credential": "CPM"
    },
    "taxonomies": [
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "OR",
            "license": "07-1611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.