Oregon Trail Health Care

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

OREGON TRAIL HEALTH CARE

Practice address

1693 SW Chandler Ave
260
Bend, OR 97702-3236

Phone

(800) 909-9220

Fax

(801) 665-1882

NPI assigned

Jul 29, 2011

Organization subpart

No

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

Authorized official

Name

Rob Miller

Title

Franchisee

Phone

(800) 909-9220

Specialties & licenses 1

Addresses

Other names 1

• PCA Pain Care Center Doing business as

Locations

Practitioners 2

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

• Jack E Berndt, MD

  • Pain Medicine Physician
  • Bend, OR
  • NPI 1467408682
  NPD (past)
• Matthew R Peterson, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bellingham, WA
  • NPI 1891785606

  Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1851679583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1693 SW CHANDLER AVE",
            "address_2": "260",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023236",
            "telephone_number": "800-909-9220",
            "fax_number": "801-665-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 SW CHANDLER AVE",
            "address_2": "260",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023236",
            "telephone_number": "800-909-9220",
            "fax_number": "801-665-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON TRAIL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "FRANCHISEE",
        "authorized_official_telephone_number": "800-909-9220"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCA Pain Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Option Care at Legacy Health LLC
• Option Care at Legacy Health LLC
• Optum Infusion Services 404, LLC
• Oregon CVS Pharmacy LLC
• Oregon Psych NP, LLC
• Oregon Vascular Specialists LLC
• Diklah Orevi, PA-C
• Gino Renzo Orlando, DDS
• Melissa R. Orman, M.D.
• Andrew Curtis Ornberg, M.A.

• All providers in Bend, OR
• Pain Medicine (Anesthesiology) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.