Northwest Neuro Nerve Monitoring, LLC

Primary specialty

Other TechnicianTaxonomy code 247200000X

Legal business name

NORTHWEST NEURO NERVE MONITORING, LLC

Practice address

1410 Oak St
Suite 100B
Eugene, OR 97401-4604

Phone

(541) 284-5358

Fax

(541) 228-3859

NPI assigned

Apr 22, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Pauline Evalyn Cole, M.H.S.A., C.A.S.C.

Title

Ceo/Administrator

Phone

(541) 228-3660

Specialties & licenses 1

Addresses

Other names 1

• NNNM Other name

Medicare fee-for-service enrollment

Enrolled in OR, GA2 enrollments

Enrollment records 2

Tax ID family

NNNM2 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.

• Northwest Neuro Nerve Monitoring

  • Electroneurodiagnostic Specialist/Technologist
  • Eugene, OR
  • NPI 1518332915
  NPD tax ID

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip C Wallace, MD

  • Physical Medicine & Rehabilitation Physician
  • Bend, OR
  • NPI 1629258322
  Medicare reassignment NPD
• Julian Alexander Bragg, MD, PHD.

  • Neurology Physician
  • Atlanta, GA
  • NPI 1164606018

  OR

  Medicare reassignment NPD
• Bruce A. Lockwood, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Ft Collins, CO
  • NPI 1093774390

  OR

  Medicare reassignment NPD
• Husham Peter Mishu, MD

  • Neurology Physician
  • Atlanta, GA
  • NPI 1326022583

  OR

  Medicare reassignment NPD
• Darin Scott Stettler, D.O.

  • Anesthesiology Physician
  • Ogden, UT
  • NPI 1578622890

  OR

  Medicare reassignment NPD
• Asa Earnest, CNIM

  • Electroneurodiagnostic Specialist/Technologist
  • Eugene, OR
  • NPI 1528699899
  NPD
• Valerie Jackson, CNIM

  • Electroneurodiagnostic Specialist/Technologist
  • Eugene, OR
  • NPI 1134593064
  NPD (past)
• Kevin Scott Mochizuki, PH.D. D.ABNM

  • Audiologist
  • Salt Lake City, UT
  • NPI 1871679787
  NPD (past)

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1841581048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 OAK ST",
            "address_2": "SUITE 100B",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014604",
            "telephone_number": "541-284-5358",
            "fax_number": "541-228-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 OAK ST",
            "address_2": "SUITE 100B",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014604",
            "telephone_number": "541-284-5358",
            "fax_number": "541-228-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST NEURO NERVE MONITORING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "EVALYN",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "541-228-3660",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.H.S.A., C.A.S.C."
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NNNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Other Technician in Eugene, OR
• Providers in Eugene, OR by specialty
• Other Technician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.