Lisa A Brandenburger, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD26928 Issued in OR

Practice address

2564 NW Edenbower Blvd
Suite 126
Roseburg, OR 97471-8821

Phone

(541) 673-2223

Fax

(541) 672-5828

NPI assigned

May 26, 2006

Last updated

Jul 3, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1841246048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712608",
            "telephone_number": "541-673-8988",
            "fax_number": "541-672-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2564 NW EDENBOWER BLVD",
            "address_2": "SUITE 126",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718821",
            "telephone_number": "541-673-2223",
            "fax_number": "541-672-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURGER",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD26928",
            "primary": true
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "OR",
            "license": "MD26928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006006",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arlene D Bradley, M.D.
• Mark Bradley
• Jessica L Brake, MS
• Tasha Renee Branch
• Lisa Brand
• Jillian Brandli
• Justin Brandmeier I, LMT
• Brannick D Adams DDS PC (Harvard Dental Group)
• Steven Craig Brantley, DO
• Baljit S Brar, PHARM D

• Gastroenterology Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Gastroenterology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.