Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Central Oregon Spine and Sports, LLC

Organization Physical Medicine & Rehabilitation Physician · NPI 1497293054

Central Oregon Spine and Sports, LLC is a Physical Medicine & Rehabilitation Physician in Bend, Oregon. Licensed in Oregon. Registered with an NPI since 2017.

Licensed in
OR
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2115 NE Wyatt Ct Ste 101
Bend, OR 97701-7678
Phone: (541) 420-4833
Fax: (541) 228-3670
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence MD152056 (OR)

Record details

NPI number1497293054
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Booher — Administrator · (541) 420-4833
NPI enumeratedFebruary 3, 2017
Last updated in NPPESFebruary 3, 2017
Mailing address2115 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7678

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