JACOB VANDERSTARRE (NPI# 1003267782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003267782 |
| Entity Type | Individual |
| Full Name | JACOB VANDERSTARRE |
| Credential | M.D. |
| Practice Address |
890 Oak St Se Bldg A Salem OR 97301 |
| Mailing Address |
890 Oak St Se Bldg A Salem OR 97301-3905 |
| Practice Telephone | 8556919890 |
| Mailing Telephone | 8556919890 |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2019-06-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MD191574 | OR | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 4301109907 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Michigan St Ne, Grand Rapids, MI 495032560 | 6163911680 |
| Street Address |
890 OAK ST SE BLDG A |
| City | SALEM |
| State | OR |
| Zip Code | 97301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477672483 | Michael Joseph Barra | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2007-03-29 |
| 1881057008 | Corby Makin | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2016-04-04 |
| 1790104784 | Jared Houck | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2014-04-07 |
| 1104177120 | Michael Oh | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2012-10-01 |
| 1003178336 | Christopher Michael Simpson | Physician Assistant | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2012-06-12 |
| 1891054953 | Ryan A Rose | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2012-05-10 |
| 1588920375 | Kyle P Hoesterey | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2012-04-05 |
| 1154525970 | Timothy Steven Duenas | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760725485 | Deirdre Harmony Witte | Emergency Medicine | Salem Emergency Physicians, C/o Salem Hospital Ed, 890 Oak St, Se, Building A, Salem, OR 97301 | 2013-04-01 |
| 1689992117 | Jillian Colleen Schmunk | Emergency Medicine | 890 Oak Street, Se, Building A, Salem Emergency Physicians Services, Salem, OR 97301 | 2010-05-07 |
| 1184894081 | Lourdes Maria Page | Emergency Medicine | 429 Homeplace Dr, Salem, VA 24153-7158 | 2008-03-06 |
| 1750589024 | Vicky L Gulley | Emergency Medicine | 35629 Hwy 72, Pob 1, Suite 3, Salem, MO 65560 | 2007-07-06 |
| 1477672483 | Michael Joseph Barra | Emergency Medicine | 890 Oak St Se Bldg A, Salem, OR 97301-3905 | 2007-03-29 |
| 1396810206 | David Austin Rideout | Emergency Medicine | 60 Washington St Ste 403, Salem, MA 01970-3517 | 2006-11-24 |
| 1134204795 | Fulton County Hospital | Emergency Medicine | 679 North Main, Salem, AR 72576 | 2006-10-25 |
| 1154336444 | Jenai E Beland Cohen | Emergency Medicine | Salem Hospital, 81 Highland Avenue, Salem, MA 01970 | 2006-07-29 |
| 1013942192 | John A Michael | Emergency Medicine | 28 1/2 Broad St, Salem, MA 01970-3143 | 2006-07-11 |
| 1447293337 | Davis K Cho | Emergency Medicine | 1002 Bellevue St Se, Salem, OR 97301-4006 | 2006-06-14 |
| Find all providers in SALEM | ||||
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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.