Northwest Cosmetic Surgery, LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD21961 Issued in OR

Legal business name

NORTHWEST COSMETIC SURGERY, LLC

Practice address

777 SW Mill View Way
Suite 100
Bend, OR 97702-1140

Phone

(541) 388-1022

Fax

(541) 322-7002

NPI assigned

Jan 8, 2008

Last updated

Jan 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary Lyle Gallagher, M.D.NPI 1770624371

Title

Manager/Member

Phone

(417) 283-1845

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary Lyle Gallagher, M.D.

  • Plastic Surgery Physician
  • Bend, OR
  • NPI 1770624371
  Authorized official Same address or phone
• Amanda K Nelson, M.D.

  • Plastic Surgery Physician
  • Bend, OR
  • NPI 1073891172
  NPD

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1841475803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SW MILL VIEW WAY STE 250",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021140",
            "telephone_number": "541-728-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SW MILL VIEW WAY",
            "address_2": "SUITE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021140",
            "telephone_number": "541-388-1022",
            "fax_number": "541-322-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST COSMETIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "417-283-1845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OR",
            "license": "MD21961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northstar Neurology LLC
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• Northwest Addiction Treatment LLC (Recover Together Bend)
• Northwest Care LLC
• Northwest Cosmetic Surgery Holdings LLC
• Northwest Footcare, LLC
• Northwest IV, LLC (Evolve Health)
• Northwest Medical Specialist LLC (NW Brain and Spine)
• Northwest Youth Discovery (Northwest Discovery)
• Northwest Youth Discovery

• Plastic Surgery Physician in Bend, OR
• Providers in Bend, OR by specialty
• Plastic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.