WILLAMETTE COMMUNITY MEDICAL GROUP (NPI# 1285819094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285819094 |
| Entity Type | Organization |
| Organization Name | WILLAMETTE COMMUNITY MEDICAL GROUP |
| Other Organization Name | THURSTON MEDICAL CLINIC |
| Practice Address |
5781 Main St Springfield OR 97478-5426 |
| Mailing Address |
4000 Meridian Blvd Attn: Debbie Brewer Franklin TN 37067-6325 |
| Practice Telephone | 5412841694 |
| Practice Fax Number | 5412424760 |
| Mailing Telephone | 6154657626 |
| Mailing Fax Number | 6154653007 |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2009-02-17 |
| Authorized Official Name | DEBBIE BREWER (DIRECTOR) |
| Authorized Official Telephone | 6154657262 |
| Is Organization Subpart | Y |
| Parent Organization Name | WILLAMETTE COMMUNITY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NPI | 1285819094 | 01 |
| Other Name | Type Code |
|---|---|
| Thurston Medical Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WILLAMETTE COMMUNITY MEDICAL GROUP, LLC | 4000 Meridian Blvd, Franklin, TN 37067 |
| Street Address |
5781 MAIN ST |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97478-5426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225014533 | Karen Poague | Physical Therapist | 5781 Main St, Springfield, OR 97478-5426 | 2005-12-19 |
| 1588042030 | Miranda Barlow | Nurse Practitioner | 5781 Main St, Springfield, OR 97478-5426 | 2015-05-15 |
| 1528356953 | Icco, LLC | Clinic/Center | 5781 Main St, Springfield, OR 97478-5426 | 2011-07-19 |
| 1104062371 | Willamette Community Medical Group, LLC | Non-Pharmacy Dispensing Site | 5781 Main St, Springfield, OR 97478-5426 | 2008-12-18 |
| 1306813795 | Oregon Medical Group At Thurston Physical Therapy | Physical Therapist | 5781 Main St, Springfield, OR 97478-5426 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588225155 | Mckenzie Dental Center | Dentist | 110 S. 59th St, Springfield, OR 97478 | 2019-06-25 |
| 1831691310 | Michael Ryan Odle | Psychologist | 36716 Oak Point Rd, Springfield, OR 97478 | 2018-03-01 |
| 1639612880 | Icco LLC | Clinic/Center | 5781 Main Street, Springfield, OR 97478 | 2016-11-21 |
| 1639529258 | Nate John Sutherland | Behavioral Analyst | 37770 Upper Creek Road, Springfield, OR 97478 | 2016-06-14 |
| 1457760134 | Leah Rybolt | Physical Therapist | 145 South 52nd Place, Springfield, OR 97478 | 2014-08-07 |
| 1972918423 | Loree Lynn Howard | Case Manager/Care Coordinator | 4145 Jasper Road, Springfield, OR 97478 | 2014-06-24 |
| 1245589753 | Sarah M Boothe | Doula | 870 S 46th St, Springfield, OR 97478 | 2012-08-30 |
| 1902155401 | Dani Maree Hill | Pharmacist | 5744 Main Street, Springfield, OR 97478 | 2012-08-30 |
| 1295005312 | Express Services Unlimited, Inc. | Non-emergency Medical Transport (VAN) | 37506 Hills Creek Road, Springfield, OR 97478 | 2012-01-05 |
| 1255524468 | Leeann D Fields | Licensed Practical Nurse | 3318 Lakeview Dr, Eugene, OR 97478 | 2007-08-21 |
| Find all providers in zip 97478 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407646 | Troutman Enterprises, LLC | Durable Medical Equipment & Medical Supplies | 5337 S Campbell Ave Ste A2, Springfield, MO 65810-2494 | 2020-11-07 |
| 1497315493 | Common Sleep, LLC | Durable Medical Equipment & Medical Supplies | 3246 S National Ave, Springfield, MO 65807-7303 | 2019-06-20 |
| 1649744467 | Mednav, LLC | Durable Medical Equipment & Medical Supplies | 53 Linden Ln, Springfield, IL 62712-8928 | 2019-01-15 |
| 1871065839 | Riverwood Medical Incorporated | Durable Medical Equipment & Medical Supplies | 7830 Backlick Rd Ste 100a, Springfield, VA 22150-2205 | 2018-12-31 |
| 1700358827 | Darlan Medical Incorporated | Durable Medical Equipment & Medical Supplies | 7830 Backlick Rd Ste 100b, Springfield, VA 22150-2205 | 2018-12-31 |
| 1912475484 | Show Me Systems LLC | Durable Medical Equipment & Medical Supplies | 3755 N State Highway H, Springfield, MO 65803-7137 | 2018-11-02 |
| 1346727567 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2155 Main Street, Suite 131/133, Springfield, MA 01104 | 2018-07-20 |
| 1720570799 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1150 N 5th St Ste B, Springfield, IL 62702-6366 | 2018-06-05 |
| 1386146405 | Slocum Orthopedics, PC | Durable Medical Equipment & Medical Supplies | 3377 Riverbend Dr Ste 300, Springfield, OR 97477-8804 | 2018-03-05 |
| 1326546045 | Howard Datz | Durable Medical Equipment & Medical Supplies | 6880 Commercial Dr # 38, Springfield, VA 22151-4201 | 2018-01-28 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97478 |
Please comment or provide details below to improve the information on WILLAMETTE COMMUNITY MEDICAL GROUP.
| 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.