DR. DANE M FICKES (NPI# 1225514375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225514375 |
| Entity Type | Individual |
| Full Name | DR. DANE M FICKES |
| Credential | PHARMD |
| Practice Address |
135 Ne Terry Ln Grants Pass OR 97526-4801 |
| Practice Telephone | 5414712820 |
| Mailing Telephone | 5414712820 |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0016659 | OR | Pharmacy Service Providers |
| Street Address |
135 NE TERRY LN |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-4801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063450013 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2006-06-03 |
| 1225686108 | Brett William Sampson | Pharmacist | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2019-09-03 |
| 1104234616 | Mariah Rossi | Pharmacist | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2014-07-28 |
| 1023426939 | Deirdre Swarts | Pharmacist | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2014-07-24 |
| 1821335977 | Fickes LLC | Optometrist | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2013-01-09 |
| 1689742132 | Eyeglass Center | Optometrist | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2006-12-01 |
| 1427126986 | Tom Fickes | Optometrist | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2006-12-01 |
| 1669540050 | Eva Fickes | Optometrist | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2006-12-01 |
| 1225055361 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 135 Ne Terry Ln, Grants Pass, OR 97526-4801 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083119994 | Timothy Warren Evans | Pharmacist | 2714 Harbeck Rd, Grants Pass, OR 97527-5630 | 2018-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194385674 | Joseph Lee Combee | Pharmacist | 4956 Sw Aster St, Corvallis, OR 97333-1367 | 2019-06-17 |
| 1538627377 | Jacquelyn Jessica Lansing | Pharmacist | 33190 Bloomberg Rd, Eugene, OR 97405-9609 | 2019-03-12 |
| 1972097699 | Nathan Daniel Hoover | Pharmacist | 1401 North 10th Ave, Stayton, OR 97383 | 2018-06-16 |
| 1144737677 | Matthew Ito | Pharmacist | 5805 Sw Delker Rd, Tualatin, OR 97062-7753 | 2018-01-05 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1336662204 | Jenny French | Pharmacist | 9427 Sw Barnes Rd Ste 295, Portland, OR 97225-6652 | 2017-07-21 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1841747649 | Richard Bennett | Pharmacist | 425 Burlwood Ave N, Monmouth, OR 97361-2252 | 2016-09-09 |
| 1316390008 | Timothy L Lichlyter | Pharmacist | 2924 Siskiyou Blvd Ste 102, Medford, OR 97504-8194 | 2016-07-18 |
| 1245695956 | M. Katherine Welch | Pharmacist | 3228 Sw Water Ave, Portland, OR 97239-4632 | 2015-12-22 |
| Find all providers with the same taxonomy | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
Please comment or provide details below to improve the information on DR. DANE M FICKES.
| 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.