COURTNEY E BROZOVICH (NPI# 1083166037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083166037 |
| Entity Type | Individual |
| Full Name | COURTNEY E BROZOVICH |
| Other Name | COURTNEY E DALKE |
| Credential | PAC |
| Practice Address |
665 Winter St Se Salem OR 97301-3934 |
| Mailing Address |
1600 State St Salem OR 97301-4257 |
| Practice Telephone | 5035412448 |
| Mailing Telephone | 5035406300 |
| Mailing Fax Number | 5035406404 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2019-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA180126 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PA LICENSE | PA180126 | 01 |
| Street Address |
665 WINTER ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659372407 | Raghunandan Kamineni | Internal Medicine | 665 Winter St Se, Suite B0350, Salem, OR 97301-3934 | 2005-08-02 |
| 1356842207 | Emily Stahl Mollenkopf | Registered Nurse | 665 Winter St Se, Salem, OR 97301-3934 | 2018-02-26 |
| 1215304092 | Caroline Houston | Pharmacist | 665 Winter St Se, Salem, OR 97301-3934 | 2015-08-27 |
| 1982008983 | Julian Mark Williams | Perfusionist | 665 Winter St Se, Salem, OR 97301-3934 | 2014-10-20 |
| 1366861775 | Andrew W Judd | Pathology | 665 Winter St Se, Bldg B 2nd Floor Pathology, Salem, OR 97301-3934 | 2014-04-14 |
| 1215215371 | Atish Chopra | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-07-23 |
| 1003106071 | Jeffrey David Crawford | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-04-12 |
| 1528357795 | Mariko Aili Ferronato | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-03-28 |
| 1174848162 | Trang Nguyen Moore | Internal Medicine | 665 Winter St Se, Salem, OR 97301-3934 | 2010-04-01 |
| 1427282409 | Natalie Ann Melrose | Internal Medicine | 665 Winter St Se, Salem, OR 97301-3934 | 2009-05-06 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374660 | Sarah Ilana Katz | Physician Assistant | 11a Laurel St, Salem, MA 01970-4657 | 2020-10-21 |
| 1306444641 | Zachary Wright | Physician Assistant | 11 Harley Ln, Salem, NH 03079-2888 | 2020-10-09 |
| 1174132195 | Andrew Yosim | Physician Assistant | 1750 Pexton Ave, Salem, VA 24153-4108 | 2020-07-27 |
| 1689202269 | Adam Joyce | Physician Assistant | 1005 Meadowrun Ct, Salem, VA 24153-6687 | 2020-03-30 |
| 1417504085 | Alexis Marie Biewend | Physician Assistant | 1645 Waln Dr Se Apt 263, Salem, OR 97306-2963 | 2019-08-19 |
| 1497309322 | Lindsey Ann Castleberry | Physician Assistant | 1111 Meadow Sage Cir, Salem, UT 84653-5578 | 2019-07-29 |
| 1134773450 | Jillian Netland | Physician Assistant | 6507 Lipscomb St Se, Salem, OR 97317-9513 | 2019-07-25 |
| 1457827354 | Gretchen Amrien | Physician Assistant | 4 Bypass Rd Ste 201, Salem, NJ 08079-2053 | 2018-10-17 |
| 1649751934 | Matthew Hansen | Physician Assistant | 875 Oak St. Se Ste 5020, Salem, OR 97301 | 2018-08-24 |
| 1487152948 | Jessica Lynn Brooks | Physician Assistant | 875 Oak St Se Ste 5060, Salem, OR 97301 | 2018-01-30 |
| 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.