Organization Active NPI

Umpqua Neurology PC

  • Neurology Physician
  • Roseburg, OR
National Provider Identifier
1881143733
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
UMPQUA NEUROLOGY PC
Practice address
1741 W Harvard Ave
Roseburg, OR 97471-2716
Phone
(541) 440-5320
Fax
(541) 440-5322
NPI assigned
Oct 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Authorized official

Name
Bobbie J Beberger
Title
Practice Administrato
Phone
(541) 440-5320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

1741 W Harvard Ave
Roseburg, OR 97471-2716

Mailing address

1741 W Harvard Ave
Roseburg, OR 97471-2716
Phone (541) 440-5320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161222000402 OR Part B Supplier - Clinic/Group Practice 7810278389 Receives reassigned benefits from 1 practitioner
Practice locations: Roseburg, OR

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": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1881143733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712716",
            "telephone_number": "541-440-5320",
            "fax_number": "541-440-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712716",
            "telephone_number": "541-440-5320",
            "fax_number": "541-440-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMPQUA NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "BEBERGER",
        "authorized_official_first_name": "BOBBIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATO",
        "authorized_official_telephone_number": "541-440-5320"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.