Provider Demographics
NPI:1407812365
Name:NORTH BEND MEDICAL CENTER INC
Entity Type:Organization
Organization Name:NORTH BEND MEDICAL CENTER INC
Other - Org Name:NBMC-MAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:TERSIGNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-267-5151
Mailing Address - Street 1:1900 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-0000
Mailing Address - Country:US
Mailing Address - Phone:541-267-5151
Mailing Address - Fax:541-266-4501
Practice Address - Street 1:1900 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-0000
Practice Address - Country:US
Practice Address - Phone:541-267-5151
Practice Address - Fax:541-266-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0000760261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR383876OtherMEDICARE OSCAR LISTED - 383876-BANDON
OR1386650778OtherNBMC DAY SURGERY NPI #
OR383853OtherMEDICARE OSCAR LISTED-383853-GOLD BEACH
OR1760404396OtherNBMC LAB NPI NUMBER
OR161133OtherMEDICAID-OMAP GROUP #
ORR0000WFBTVOtherGROUP MEDICARE PIN NUMBER
OR1063428308OtherNBMC XRAY-EKG NPI NUMBER
OR1063428308OtherNBMC XRAY-EKG NPI NUMBER
ORR0000WFBTVOtherGROUP MEDICARE PIN NUMBER
OR1063428308OtherNBMC XRAY-EKG NPI NUMBER
OR383876OtherMEDICARE OSCAR LISTED - 383876-BANDON