KEVIN MICHAEL DENNIS (NPI# 1063795003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063795003 |
| Entity Type | Individual |
| Full Name | KEVIN MICHAEL DENNIS |
| Credential | PAC |
| Practice Address |
875 Oak St Se Suite 5020 Salem OR 97301-3975 |
| Mailing Address |
975 Se Sandy Blvd Suite 201 Portland OR 97214-1308 |
| Practice Telephone | 5033714044 |
| Practice Fax Number | 5033714356 |
| Mailing Telephone | 5032360775 |
| Mailing Fax Number | 5032360786 |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2012-02-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA156037 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1063795003 | 05 | |
| OR | 500639220 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043587058 | Kevin Dennis | Occupational Therapist | 810 W Weaver Rd, Springfield, MO 65810-1554 | 2011-11-18 |
| 1740268861 | Kevin Odell Dennis | Family Medicine | 2000 Mallory Ln, Suite 130-256, Franklin, TN 37067-8209 | 2006-01-09 |
| Street Address |
875 OAK ST SE SUITE 5020 |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952307498 | Jerry Leroy Hubbard | Neurological Surgery | 875 Oak St Se, Ste 5060, Salem, OR 97301-3987 | 2005-06-21 |
| 1710447453 | Katie Joy Larue | Pharmacist | 875 Oak St Se, Salem, OR 97301-3975 | 2019-03-20 |
| 1538600333 | Rachel Wixson | Nurse Practitioner | 875 Oak St Se, Salem, OR 97301-3975 | 2017-03-13 |
| 1265971386 | Angela Rehder | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301 | 2017-02-22 |
| 1548625585 | Hematology Oncology of Salem, LLP | Physician Assistant | 875 Oak St Se, Suite 4030, Salem, OR 97301-3975 | 2015-12-17 |
| 1841664752 | Healogics Specialty Physicians of Oregon, LLC | Emergency Medicine | 875 Oak St Se, Salem, OR 97301-3975 | 2015-11-17 |
| 1134592041 | Oregon Oncology Specialists, LLP | Internal Medicine | 875 Oak St Se, Suite 4030, Salem, OR 97301-3975 | 2015-11-02 |
| 1841693363 | Charles V. Hatchette II, Md, LLC | Neurological Surgery | 875 Oak St Se, Suite 5060, Salem, OR 97301-3975 | 2014-09-29 |
| 1770997009 | Urooba Faheem | Psychiatry & Neurology | 875 Oak St Se, Salem, OR 97301-3975 | 2014-06-14 |
| 1689922676 | Michael Christian Slabaugh | Physician Assistant | 875 Oak St Se, Ste 3010, Salem, OR 97301 | 2012-08-22 |
| Find all providers in the same location | ||||
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245538990 | Megan S Welch | Physician Assistant | 16 Pelham Rd Ste 1, Salem, NH 03079 | 2011-03-04 |
| 1265971386 | Angela Rehder | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301 | 2017-02-22 |
| 1942757224 | Rebecca Theisen | Physician Assistant | 1600 State St, Salem, OR 97301-4257 | 2016-09-05 |
| 1184965253 | Casey Lewis Shaw | Physician Assistant | 1600 State St, Salem, OR 97301-4257 | 2013-03-13 |
| 1093062960 | Christopher J Shields | Physician Assistant | 16 Pelham Rd, Ste 1, Salem, NH 03079-2826 | 2012-08-10 |
| 1851658975 | Nicole L Kehrer | Physician Assistant | 1600 State St, Salem, OR 97301-4257 | 2012-04-13 |
| 1386948347 | Timothy Tseng | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2011-01-05 |
| 1144520453 | Melissa Brooke Barone | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301-3975 | 2010-11-02 |
| 1700110616 | Dana Nicole Schenker | Physician Assistant | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2009-09-24 |
| 1245564491 | Joshua Glenn Andrew | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301-3975 | 2009-09-21 |
| 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.