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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
Street Address |
1111 CRATER LAKE AVE |
City | MEDFORD |
State | OR |
Zip Code | 97504-6241 |
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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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 |
Find all providers in zip 97504 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
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. |
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 |
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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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.