MOSAIC MEDICAL MOBILE UNIT (NPI# 1588902860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588902860 |
| Entity Type | Organization |
| Organization Name | MOSAIC MEDICAL MOBILE UNIT |
| Practice Address |
2084 Ne Professional Ct Bend OR 97701-6077 |
| Mailing Address |
375 Nw Beaver St Suite 101 Prineville OR 97754-1802 |
| Practice Telephone | 5413833005 |
| Practice Fax Number | 5413831883 |
| Mailing Telephone | 5414470707 |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2015-06-30 |
| Authorized Official Name | MEGAN HAASE (CEO) |
| Authorized Official Telephone | 5414470707 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | Y |
| Parent Organization Name | MOSAIC MEDICAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 182960 | 05 |
| Street Address |
2084 NE PROFESSIONAL CT |
| City | BEND |
| State | OR |
| Zip Code | 97701-6077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902881592 | Joeth D. Ryan | Physician Assistant | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2005-12-07 |
| 1801445473 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2019-09-06 |
| 1821591199 | Lauren Kaimana Oakley | Dental Hygienist | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-03-13 |
| 1528560091 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-03-01 |
| 1659888279 | Mosaic Medical Dental | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-01-04 |
| 1407309115 | Megan L. Barrett | Registered Nurse | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2016-07-28 |
| 1811314040 | William Featherston Gilmore IIi | Pediatrics | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2014-03-26 |
| 1790109189 | Lindsey Renae Overstreet | Social Worker | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2014-02-06 |
| 1972938942 | Kerry Adele Gillette | Physician Assistant | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-09-10 |
| 1851732085 | Joshua Reiher | Family Medicine | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1083252472 | Driven Enterprises PC | Family Medicine | 20700 Wandalea Dr, Bend, OR 97701-1594 | 2019-12-16 |
| 1407404668 | Taylor Rose Stockton | Family Medicine | 19700 Sunshine Way, Bend, OR 97702-1984 | 2019-08-30 |
| 1366780066 | Anthony Gunsul | Family Medicine | 61250 Se Coombs Place, Bend, OR 97702 | 2013-01-30 |
| 1669776050 | Ralph Verlin Litchfield | Family Medicine | 21260 Bear Creek Rd, Bend, OR 97701-9602 | 2010-12-29 |
| 1750681391 | Kevin Michael Fickenscher Sr. | Family Medicine | 3499 Nw Braid Drive, Bend, OR 97701-8682 | 2010-10-29 |
| 1902030844 | Audrey H Davey | Family Medicine | 18976 Nw Squirreltail Loop, Bend, OR 97703-5932 | 2009-05-06 |
| 1366609422 | Jon Arthur Blackman | Family Medicine | 2456 Nw Sacagawea Ln, Bend, OR 97701-5722 | 2008-05-16 |
| 1316060163 | West Bend Family Medicine | Family Medicine | 2855 Nw Crossing Dr., Suite 102, Bend, OR 97703 | 2007-04-09 |
| 1962544106 | Paul Vancamp | Family Medicine | 115 Sw Allen Rd, Bend, OR 97702-3170 | 2007-02-13 |
| Find all providers in BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.