Oregon Retina, LLP

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD20042 Issued in OR

Legal business name

OREGON RETINA, LLP

Practice address

855 W Central Blvd
Coquille, OR 97423-1095

Phone

(541) 762-2763

NPI assigned

Jan 9, 2014

Organization subpart

No

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

Authorized official

Name

Albert Edwards, MD, PHD

Title

Physician/Owner

Phone

(541) 762-2763

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Oregon Retina, LLP

  • Ophthalmology Physician
  • Newport, OR
  • NPI 1467717405

  O20121018000464

  Same enrollment
• Oregon Retina, LLP

  • Ophthalmology Physician
  • Gold Beach, OR
  • NPI 1750703575

  O20121018000464

  Same enrollment
• Sterling Vision, PC

  • Ophthalmology Physician
  • Eugene, OR
  • NPI 1902161946

  O20121018000464

  Same enrollment

Locations

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1962824060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 OAK ST",
            "address_2": "SUITE 4",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017701",
            "telephone_number": "541-762-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 W CENTRAL BLVD",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231095",
            "telephone_number": "541-762-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON RETINA, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "541-762-2763",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD20042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lonny Jay Morley, B.S., L.M.T.
• Laura Nevdal, RPH
• Christine Nguyen
• Lyle Kevin Norton, DC
• Oregon Hearing Professionals, Inc.
• Pacific Sleep & Respiratory Diagnostics, LLC
• Pahls Dentistry PC
• Christian Brent Pahls, D.D.S.
• Herman Christian Pahls, DDS
• Pathfinders Behavioral Health LLC

• Ophthalmology Physician in Coquille, OR
• Providers in Coquille, OR by specialty
• Ophthalmology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.