Organization Active NPI

White City Cboc

  • VA Clinic/Center
  • White City, OR
National Provider Identifier
1871537258
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
WHITE CITY CBOC
Practice address
8495 Crater Lake Hwy
White City, OR 97503-3011
Phone
(541) 826-2111
Fax
(541) 830-3500
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Barbara Mayerick
Title
Director, Business Development
Phone
(202) 254-0339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

8495 Crater Lake Hwy
White City, OR 97503-3011

Mailing address

8495 Crater Lake Hwy
White City, OR 97503-3011
Phone (541) 826-2111

National Provider Directory

National Provider Directory
Tax ID family
Dept of Veterans Affair6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871537258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8495 CRATER LAKE HWY",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975033011",
            "telephone_number": "541-826-2111",
            "fax_number": "541-830-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8495 CRATER LAKE HWY",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975033011",
            "telephone_number": "541-826-2111",
            "fax_number": "541-830-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE CITY CBOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYERICK",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "202-254-0339"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.