BEND DERMATOLOGY CLINIC LLC (NPI# 1649244393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649244393 |
| Entity Type | Organization |
| Organization Name | BEND DERMATOLOGY CLINIC LLC |
| Practice Address |
2747 Ne Conners Ave Bend OR 97701-8738 |
| Practice Telephone | 5413825712 |
| Practice Fax Number | 5413822605 |
| Mailing Telephone | 5413825712 |
| Mailing Fax Number | 5413822605 |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2010-06-17 |
| Authorized Official Name | SUZANNE MAITLAND (OFFICE MANAGER) |
| Authorized Official Telephone | 5413825712 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 286941 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548412224 | Bend Dermatology Clinic LLC | Clinical Medical Laboratory | 2705 Ne Conners Ave, Bend, OR 97701-6904 | 2008-10-14 |
| Street Address |
2747 NE CONNERS AVE |
| City | BEND |
| State | OR |
| Zip Code | 97701-8738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972073260 | Matthew Joseph Trautman | Physician Assistant | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2018-11-29 |
| 1447764741 | Mountain West Derm - Blackhart Pllc | Dermatology | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2017-11-22 |
| 1427282383 | Kristin Jayne Neuhaus | Dermatology | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2009-05-06 |
| 1538366240 | Joshua Stafford May | Dermatology | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2007-06-27 |
| 1275744971 | Stephanie Alice Trautman | Dermatology | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2007-05-24 |
| 1265521280 | Allison M Mckean | Physician Assistant | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2006-10-11 |
| 1790704591 | Larry M Weber | Physician Assistant | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2006-07-19 |
| 1952327405 | Amanda K Kleven | Physician Assistant | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2006-07-15 |
| 1982629713 | Douglas K Zirker | Dermatology | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2006-07-13 |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417207283 | Karla S Pivik | Dermatology | 2195 Nw Shevlin Park Rd, Suite 100, Bend, OR 97703-7102 | 2012-09-19 |
| 1164545166 | Oliver Jayme Wisco | Dermatology | Dermatology Health Spcecialist, 1693 Sw Chandler Ave Suite 250, Bend, OR 97702-3231 | 2007-04-06 |
| 1891703021 | Gerald E Peters Jr. | Dermatology | 2041 Ne Williamson Ct, Ste B, Bend, OR 97701-3925 | 2006-08-03 |
| 1962431627 | Leslie A. Carter M.d., LLC | Dermatology | 325 Sw Upper Terrace Dr., Suite 100, Bend, OR 97702 | 2006-07-02 |
| 1609815166 | Mark A Hall | Dermatology | 388 Sw Bluff Dr, Bend, OR 97702-1360 | 2006-06-06 |
| 1366492530 | Dawn S. Allison, Md, PC | Dermatology | 1510 Nancy Way, Bend, OR 97702-3215 | 2006-05-11 |
| 1730168014 | Leslie Ann Carter | Dermatology | 325 Sw Upper Terrace Dr, Suite 100, Bend, OR 97702-1900 | 2006-01-13 |
| 1396745303 | Jill M Olinger | Dermatology | 815 Sw Bond St, Bend, OR 97702 | 2005-08-01 |
| 1447764741 | Mountain West Derm - Blackhart Pllc | Dermatology | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2017-11-22 |
| 1871954214 | Peters Dermatology Center | Dermatology | 2041 Ne Williamson Ct, Ste B, Bend, OR 97701-3925 | 2016-03-13 |
| 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.