NPIMap

Organization Active NPI

Oregon Retina, LLP

  • Ophthalmology Physician
  • Bandon, OR
National Provider Identifier
1962824821
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD20042 Issued in OR
Legal business name
OREGON RETINA, LLP
Practice address
1095 Alabama Street
Bandon, OR 97411
Phone
(541) 762-2763
NPI assigned
Jan 13, 2014
Last updated
Jan 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Authorized official

Name
Albert O Edwards, MD, PH/DNPI 1215930763
Title
Physician/Owner
Phone
(541) 762-2763

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD20042 OR Primary

Addresses

Primary practice location

1095 Alabama Street
Bandon, OR 97411

Mailing address

1550 Oak St
Suite 4
Eugene, OR 97401-7701
Phone (541) 762-2763

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1962824821",
    "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",
            "fax_number": "541-434-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 ALABAMA STREET",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "97411",
            "telephone_number": "541-762-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON RETINA, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "541-762-2763",
        "authorized_official_credential": "MD, PH/D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD20042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bandon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.