Shift Bend Functional Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHIFT BEND FUNCTIONAL MEDICINE

Practice address

151 SW Shevlin Hicks Dr
Suite #1
Bend, OR 97702

Phone

(541) 219-1910

NPI assigned

Dec 26, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Marie Agnew, FNP-C, DNP

Title

Owner and Medical Provider

Phone

(541) 219-1910

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577318400000",
    "number": "1962041707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 NW TRENTON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031126",
            "telephone_number": "541-219-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SW SHEVLIN HICKS DR",
            "address_2": "SUITE #1",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-219-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFT BEND FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-26",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A",
        "authorized_official_last_name": "AGNEW",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OWNER AND MEDICAL PROVIDER",
        "authorized_official_telephone_number": "541-219-1910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP-C, DNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Daniel Sherfield, CRM
• Pema Lhamu Sherpa, R.D.H
• Sean Patrick Sherry, DDS
• Shevlin Dental Center
• Lauren Beth Shields, AGACNP-BC, DNP
• Terry Shih, M.D.
• Tracy Ann Shinkle, R.PH.
• Kathleen Shipley, MA
• Janet M Shipps, LPN
• William Ward Shirk, OPTOMETRIST

• Family Medicine Physician in Bend, OR
• Providers in Bend, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.