JEFFERY KOLK HERBERT (NPI# 1174604359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174604359 |
| Entity Type | Individual |
| Full Name | JEFFERY KOLK HERBERT |
| Credential | P.A. |
| Practice Address |
520 Medical Center Dr Suite 300 Medford OR 97504-4334 |
| Practice Telephone | 5412826685 |
| Practice Fax Number | 5412826686 |
| Mailing Telephone | 5412826685 |
| Mailing Fax Number | 5412826686 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 363A00000X | Physician Assistant | PA00572 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00572 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| X | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA00572 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | BLUE CROSS | 4898008 | 01 |
| OR | 064456 | 05 |
| Street Address |
520 MEDICAL CENTER DR SUITE 300 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-4334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922095199 | Joel A Tobias | Internal Medicine | 520 Medical Center Dr, Suite 200, Medford, OR 97504-4314 | 2005-10-04 |
| 1033588546 | Daniel Neville | Physician Assistant | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2015-09-15 |
| 1063855161 | App Cardiovascular Surgeons | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2013-04-09 |
| 1205180098 | Stephani Kathleen Cook | Physician Assistant | 520 Medical Center Dr, Suite 300, Medford, OR 97504-4334 | 2012-11-01 |
| 1790014074 | Christopher Charles Davis | Physician Assistant | 520 Medical Center Dr, Suite 300, Medford, OR 97504-4334 | 2009-12-15 |
| 1033444781 | Southern Oregon Cardiology LLC | Internal Medicine | 520 Medical Center Dr, Ste 200, Medford, OR 97504-4314 | 2009-10-14 |
| 1104056092 | Dani J Thomas | Internal Medicine | 520 Medical Center Dr, Suite 2001, Medford, OR 97504-4334 | 2009-07-26 |
| 1265675599 | Natalie E Baxter | Physician Assistant | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4334 | 2009-04-16 |
| 1629267414 | Pamela Reeger Cortell | Nurse Practitioner | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2007-10-17 |
| 1144412529 | Patrick Joseph Phelan | Surgery | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2007-08-09 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1548867856 | Megan Elaine Stewart | Physician Assistant | 3773 Pinetop Dr, Medford, OR 97504-9638 | 2020-10-08 |
| 1811506355 | Nicholas Fantony | Physician Assistant | 28 Leyden St, Medford, MA 02155-6674 | 2020-07-30 |
| 1033739164 | Giana Brunetti | Physician Assistant | 2 Liverpool Way, Medford, NJ 08055-4023 | 2020-04-18 |
| 1881238087 | Rosivel Flores | Physician Assistant | 853 Old Medford Ave, Medford, NY 11763-3521 | 2019-10-30 |
| 1942844386 | Aileen Yaeger | Physician Assistant | 30 Syracuse Ave, Medford, NY 11763-3621 | 2019-10-29 |
| 1568949477 | Evan Xanthos | Physician Assistant | 1600 Delta Waters Rd Ste 107, Medford, OR 97504-9114 | 2018-07-24 |
| 1104369099 | Cullen Anthony Mack | Physician Assistant | 235 E Barnett Rd, Suite 106, Medford, OR 97501-7901 | 2016-11-23 |
| 1053863662 | Mark Thomas Kestner | Physician Assistant | 44 Manning St, Medford, MA 02155-4422 | 2016-10-30 |
| 1972058840 | Victoria Rose Acilio | Physician Assistant | 103 Old Marlton Pike Ste 201, Medford, NJ 08055-8772 | 2016-08-22 |
| 1962896944 | Jeremy Klimar | Physician Assistant | 407 Jesse Ct, Medford, NY 11763-2139 | 2015-03-26 |
| Find all providers in MEDFORD | ||||
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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.