PROVIDENCE HOSPITALISTS & INTENSIVISTS


Address: 1111 Crater Lake Ave, Medford, OR 97504-6241
Phone: 5414942035

PROVIDENCE HOSPITALISTS & INTENSIVISTS (NPI# 1063462232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063462232
Entity Type Organization
Organization Name PROVIDENCE HOSPITALISTS & INTENSIVISTS
Practice Address 1111 Crater Lake Ave
Medford
OR 97504-6241
Mailing Address 1208 Beall Ln
Central Point
OR 97502-1573
Practice Telephone 5414942035
Practice Fax Number 5414942002
Mailing Telephone 5416645151
Mailing Fax Number 5416645155
Enumeration Date 2006-05-11
Last Update Date 2009-05-22
Authorized Official Name MICHAEL STRASSER (CEO)
Authorized Official Telephone 5414942035
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 1111 CRATER LAKE AVE
City MEDFORD
State OR
Zip Code 97504-6241

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558361378 Craig S. Thalacker Emergency Medicine 1111 Crater Lake Ave, Medford, OR 97504-6241 2005-07-22
1447865464 Annabel M Walker Nurse Practitioner 1111 Crater Lake Ave, Medford, OR 97504-6241 2020-09-15
1386256519 Ryan Tierney Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2020-08-19
1992362867 Courtney Howarth Physical Therapy Assistant 1111 Crater Lake Ave, Medford, OR 97504-6241 2019-05-24
1811470107 Nicole Marie Choyce Dietitian, Registered 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-09-12
1336621721 Tai Bailey Shelton Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-31
1932681533 Jacqueline Lucas-morris Occupational Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-30
1477035236 Sarah Rae Hanley Occupational Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-29
1306327242 Elizabeth Carlton Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-28
1851872428 Ida Marielke Funke Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225673833 Lydia D Sneed Behavioral Analyst 3707 Citation Way, Suite 102, Medford, OR 97504 2019-11-07
1114577368 Heather Ashley Fronek Nurse Practitioner 2825 E. Barnett Rd., Medford, OR 97504 2019-09-18
1255809109 Justin Blasdel Technician, Health Information 3250 Lone Pine Rd, Medford, OR 97504 2018-11-08
1396220133 Aimee K Michel Massage Therapist 3550 National Dr., Medford, OR 97504 2018-09-27
1437646908 Zola Dental Medford LLC Dentist 922 E Main, Medford, OR 97504 2018-04-19
1376068015 Megan Leggett Counselor 777 Murphy Road, Medford, OR 97504 2017-08-03
1023547536 Joshua Morgan Rice Dentist 1117 E Main St Ste 1, Medford, OR 97504 2017-06-08
1427580232 Paul James Dean Counselor 1175 Main St Ste 1c, Medford, OR 97504 2017-03-30
1811443542 Taya Adams Doula 1201 Progress Dr #90, Medford, OR 97504 2016-09-01
1174076228 Avalon Health Care - Hearthstone, LLC Skilled Nursing Facility 2091 E. Barnett Road, Medford, OR 97504 2016-07-25
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Taxonomy Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912314279 Rishi Shravan Arora Internal Medicine 555 Black Oak Dr Ste 300, Medford, OR 97504-8491 2014-07-18
1669815700 App-rrmc Intensivists Internal Medicine 2825 E Barnett Rd, Medford, OR 97504-8332 2013-04-08
1033484506 Margaret Sara Fairhurst Internal Medicine 1698 E Mcandrews Rd Ste 400, Medford, OR 97504-5590 2012-03-17
1427339738 Diya F Mohammad Internal Medicine 2825 E. Barnett Rd, Medford, OR 97504-8332 2011-08-31
1962698712 Somnath Ghosh Internal Medicine 2825 East Barnett Rd, Medford, OR 97504 2007-09-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1548587660 Anna Kristin Brady Internal Medicine 3181 Sw Sam Jackson Park Rd # 67, Portland, OR 97239-3011 2010-04-29
1447417100 Mary Suzanne Mckenzie Internal Medicine 19250 Sw 65th Ave Ste 137, Tualatin, OR 97062-7745 2008-05-20
1316142425 Fayez A. Bader Internal Medicine 801 Mission St. Se, Salem, OR 97302-6217 2007-06-19
1780707174 Wheeler John Dale Internal Medicine 5060 Sw Philomath Blvd, # 512, Corvallis, OR 97333 2007-04-09
1699869255 Ralph A Juarez Internal Medicine 10201 Se Main St Ste 11, Portland, OR 97216-2937 2006-10-03
1285731059 Catherine J Markin Internal Medicine 2222 Nw Lovejoy St., Mob 1 Suite 411, Portland, OR 97210 2006-09-20
1477520120 Poh Hock Leng Internal Medicine 2222 Nw Lovejoy St Ste 411, Portland, OR 97210-5102 2006-03-01
1407832868 Razvan I Gosman Internal Medicine 2460 Nw Stewart Pkwy, Suite 103, Roseburg, OR 97471-1516 2005-12-19
1629054085 Luana Ionela Petre Nedita Internal Medicine 2460 Nw Stewart Parkway, Suite 103, Roseburg, OR 97471-1516 2005-12-19
1952885659 Amy Purkey Internal Medicine 890 Oak St Se, Salem, OR 97301-3905 2018-09-18
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Competitor

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City MEDFORD
Zip Code 97504

Improve Information

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Dataset Information

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.

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