Pacific Spine & Rehab, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MD27619 Issued in OR

Legal business name

PACIFIC SPINE & REHAB, LLC

Practice address

2480 Liberty St NE
Ste 180
Salem, OR 97301-8388

Phone

(503) 364-1990

Fax

(503) 391-4688

NPI assigned

Aug 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert D. Heros, M.D.

Title

Owner / Member

Phone

(503) 364-1990

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1992999536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LIBERTY ST NE",
            "address_2": "STE 180",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018388",
            "telephone_number": "503-364-1990",
            "fax_number": "503-391-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LIBERTY ST NE",
            "address_2": "STE 180",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018388",
            "telephone_number": "503-364-1990",
            "fax_number": "503-391-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SPINE & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "HEROS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER / MEMBER",
        "authorized_official_telephone_number": "503-364-1990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "MD27619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Pathology Associates, Inc
• Pacific Pathology Associates, Inc
• Pacific Pathology Associates, Inc.
• Pacific Premier Care Home LLC
• Pacific Recovery Inc
• Samuel William Packham, PA-C
• Victoria R Padron, RD, LD, CD
• Michelle Lyn Pagel, B.S
• Pain Care Specialists of Oregon, LLC
• Pain Care Specialists, PC

• Medical Specialty Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.