NPIMap

Organization Active NPI

Northwest Cosmetic Surgery Holdings LLC

  • Plastic Surgery Physician
  • Bend, OR
National Provider Identifier
1851939953
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
NORTHWEST COSMETIC SURGERY HOLDINGS LLC
Practice address
777 SW Mill View Way Ste 100
Bend, OR 97702-1140
Phone
(541) 388-1022
Fax
(541) 322-7002
NPI assigned
Dec 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Authorized official

Name
Amanda K Nelson, MDNPI 1073891172
Title
President and Secretary
Phone
(541) 388-1022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

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

Mailing address

777 SW Mill View Way Ste 100
Bend, OR 97702-1140
Phone (541) 388-1022

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1851939953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SW MILL VIEW WAY STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021140",
            "telephone_number": "541-388-1022",
            "fax_number": "541-322-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SW MILL VIEW WAY STE 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 HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "541-388-1022",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.