DR. JACK HOWARD SIMON (NPI# 1083786024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083786024 |
| Entity Type | Individual |
| Full Name | DR. JACK HOWARD SIMON |
| Other Name | DR. JACK HOWARD SIMON |
| Credential | M.D.,PH.D. |
| Practice Address |
3710 Sw Veterans Hospital Rd Portland Va Medical Center Portland OR 97207 |
| Mailing Address |
Po Box 3980 Wilsonville OR 97070-1540 |
| Practice Telephone | 3038192848 |
| Mailing Telephone | 3038192848 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2085N0700X |
Radiology Specialization: Neuroradiology |
23522 | CO | Allopathic & Osteopathic Physicians |
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
23522 | CO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861694135 | Jack Simon | Psychiatry & Neurology | 164 Main St, Los Altos, CA 94022-2928 | 2007-05-31 |
| Street Address |
3710 SW VETERANS HOSPITAL RD PORTLAND VA MEDICAL CENTER |
| City | PORTLAND |
| State | OR |
| Zip Code | 97207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003847849 | Deborah Janet Cohen | Radiology | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2006-07-06 |
| 1215540943 | Stephanie Suzanne Brown | Social Worker | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-08-24 |
| 1003478587 | Elizabeth Grover | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2019-07-03 |
| 1356829915 | Meghan L Kauffman | Registered Nurse | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2018-08-04 |
| 1760991954 | Amber Ann Bisnu | Licensed Practical Nurse | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2017-09-20 |
| 1659802494 | Corey Stephen Malensek | Dentist | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2017-03-23 |
| 1447604533 | Milynn Henkel | Dental Assistant | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2016-04-14 |
| 1750788790 | Kimberly Kauzlarich | Pharmacist | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2014-11-19 |
| 1306109897 | Ellen Lee | Optometrist | 3710 Sw Veterans Hospital Rd, R&d 14, Portland, OR 97239-2964 | 2012-06-19 |
| 1669702148 | Rebecca Louise Guild | Dentist | 3710 Sw Veterans Hospital Rd, Portland, OR 97239-2964 | 2010-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134285620 | Natalia Hanavan | Orthotist | 3710 Sw Us Veteran's Hospital Rd, Portland, OR 97207 | 2006-12-29 |
| 1659435915 | Mary Catherine Russell | Nurse Practitioner | 3710 Sw Us Veterans Hosp Rd, Portland, OR 97207 | 2006-12-21 |
| 1467545996 | Michael Philip Resnick | Psychiatry & Neurology | 3181 Ssam Jackson Park Rd, Portland, OR 97207 | 2006-10-02 |
| 1609969435 | Patricia A Sosnovec | Nurse Practitioner | 3710 Sw Us Veterans Hospital Road V3-mhd, Portland, OR 97207 | 2006-10-02 |
| 1447358866 | Alison Elaine Hopkins | Nurse Practitioner | 3710 Sw Us, Veterans Hospital Road, Portland, OR 97207 | 2006-09-20 |
| 1518060805 | Michael Vernon Eddington | Social Worker | Va Medical Center(v3cnh), Sam Jackson Blvd, Portland, OR 97207 | 2006-09-05 |
| 1194827493 | Charlotte Ann Sunderland | Nurse Practitioner | Veterans Medical Center, P3 Card, Division of Cardiolog, Us Veterans Hospital Road, Portland, OR 97207 | 2006-09-05 |
| 1134237621 | Linda Louise Humphrey | Internal Medicine | 3710 Sw Us Vetserans Hospital Rd, Portland, OR 97207 | 2006-08-26 |
| 1821105222 | Gina L Ortola | Psychologist | Portland Vamc, 3710 Sw Us Veterans Hospital Road, Portland, OR 97207 | 2006-08-23 |
| 1841307238 | Matthew Peter Kaul | Physical Medicine & Rehabilitation | 3710 Sw Us Veteran's Hospital Rd., Portland, OR 97207 | 2006-08-23 |
| Find all providers in zip 97207 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053556035 | Ching-wen Angela Chang | Radiology | 3570 Sw River Pkwy, Unit 1509, Portland, OR 97239-4534 | 2008-12-04 |
| 1861441560 | Stephen Michael Blum | Radiology | 1001 Nw Lovejoy St, Unit 706, Portland, OR 97209-3566 | 2006-05-09 |
| 1932162906 | Portland Medical Imaging LLC | Radiology | 10538 Se Washington St, Portland, OR 97216-2809 | 2006-04-10 |
| 1871102459 | Gregory Ochieng Obala | Radiology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-07-29 |
| 1982046868 | Nadine Mallak | Radiology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2013-07-22 |
| 1346514189 | Joao Prola Netto | Radiology | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2012-02-24 |
| 1750678710 | David Allen Creed | Radiology | 3181 Sw Sam Jackson Park Rd, Ohsu Diagnostic Radiology L340, Portland, OR 97239-3011 | 2011-06-28 |
| 1457665473 | James Brian Allison | Radiology | 22 Bramhall St, Portland, ME 04102-3134 | 2010-08-02 |
| 1952622300 | Ramon Francisco Barajas Jr. | Radiology | 3181 Sw Sam Jackson Park Rd, Cr 135, Portland, OR 97239-3011 | 2010-06-21 |
| 1215256391 | Leslie Jay Starkey | Radiology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2010-05-27 |
| Find all providers in PORTLAND | ||||
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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.