CENTRAL OREGON CLINICAL GENETICS CENTER, LLC (NPI# 1740572221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740572221 |
| Entity Type | Organization |
| Organization Name | CENTRAL OREGON CLINICAL GENETICS CENTER, LLC |
| Practice Address |
143 Sw Shevlin Hixon Dr Suite #203 Bend OR 97702-3189 |
| Practice Telephone | 5417498196 |
| Practice Fax Number | 5416785466 |
| Mailing Telephone | 5417498196 |
| Mailing Fax Number | 5416785466 |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2012-03-14 |
| Authorized Official Name | DR. OSVALDO ANTONIO SCHIRRIPA (DIRECTOR/OWNER) |
| Authorized Official Telephone | 5417498196 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
MD153157 | OR | Ambulatory Health Care Facilities |
| N | 291U00000X | Clinical Medical Laboratory | A46201 | CA | Laboratories |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD153157 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500637246 | 05 | |
| OR | 500637292 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CENTRAL OREGON CLINICAL GENETICS CENTER, LLC | 143 Sw Shevlin Hixon Drive Suite 203, Bend, OR 97702 |
| Street Address |
143 SW SHEVLIN HIXON DR SUITE #203 |
| City | BEND |
| State | OR |
| Zip Code | 97702-3189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336264373 | Osvaldo A. Schirripa | Medical Genetics | 143 Sw Shevlin Hixon Dr, Suite #203, Bend, OR 97702-3189 | 2007-03-20 |
| 1144866096 | Katie Ford Lpc Mft | Clinic/Center | 143 Sw Shevlin Hixon Dr, Bend, OR 97702-3189 | 2019-11-25 |
| 1366805749 | Mark Dunn | Naturopath | 143 Sw Shevlin Hixon Dr, Ste 202, Bend, OR 97702-3189 | 2016-04-01 |
| 1740578202 | Kristen Nicole Gaus Mikkelson | Optometrist | 143 Sw Shevlin Hixon Dr, Suite 101, Bend, OR 97702-3189 | 2011-07-19 |
| 1811285679 | Dan Hicks | Counselor | 143 Sw Shevlin Hixon Dr, Suite 201, Bend, OR 97702-3189 | 2011-07-14 |
| 1811164874 | Mary Miller | Counselor | 143 Sw Shevlin Hixon Dr, Suite 202, Bend, OR 97702-3189 | 2008-05-09 |
| 1619152485 | Patrick Ayres, Od, PC | Optometrist | 143 Sw Shevlin Hixon Dr, Suite 101, Bend, OR 97702-3189 | 2007-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026466 | Kyle D. Homertgen Bend Osteopathic Care PC | Clinic/Center | 147 Sw Shevlin Hixon Dr Ste 204, Bend, OR 97702-1137 | 2020-09-02 |
| 1417316191 | Ronald Guiley Od, Mph, PC | Clinic/Center | 63455 N Hwy 97, Ste 75, Bend, OR 97703 | 2016-02-23 |
| 1356745301 | Deschutes Health LLC | Clinic/Center | 612 Ne Savannah Dr, Suite 1, Bend, OR 97701-4874 | 2014-10-20 |
| 1720331994 | Wendy Weintrob Inc | Clinic/Center | 701 Nw Arizona Ave, Suite 200, Bend, OR 97701-3298 | 2012-10-24 |
| 1467951962 | Active Motion Chiropractic | Clinic/Center | 2955 N Hwy 97, Bend, OR 97703-7559 | 2018-02-09 |
| 1295274520 | Pure Light Family Chiropractic, LLC | Clinic/Center | 155 Sw Century Dr, Bend Pilates, Bend, OR 97702-1657 | 2017-02-20 |
| 1043653777 | Gary D Buchholz Md PC | Clinic/Center | 2275 Ne Doctors Dr, Suite 9, Bend, OR 97701-6324 | 2013-04-11 |
| 1174868020 | Bend Osteopathic Care, PC | Clinic/Center | 147 Sw Shevlin Hixon Dr, Suite 204, Bend, OR 97702-3130 | 2012-12-04 |
| 1073886412 | Lifetime Vision Care LLC | Clinic/Center | 901 Nw Carlon Ave, Suite 2, Bend, OR 97703-2636 | 2012-02-15 |
| 1407021348 | Glenn M Koteen M.d., LLC | Clinic/Center | 2450 Ne Mary Rose Pl, Ste 210, Bend, OR 97701-7132 | 2008-04-22 |
| 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.