DANA ALEXZANDRIA BOGDANOVE (NPI# 1396351730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396351730 |
| Entity Type | Individual |
| Full Name | DANA ALEXZANDRIA BOGDANOVE |
| Credential | PSS |
| Practice Address |
140 S Holly St Medford OR 97501-3113 |
| Mailing Address |
220 W Rapp Rd Unit 113 Talent OR 97540-8676 |
| Practice Telephone | 5417748200 |
| Mailing Telephone | 5413242134 |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | NA | OR | Other Service Providers |
| Street Address |
140 S HOLLY ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-3113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710087333 | Elizabeth Ann Pischel | Advanced Practice Midwife | 140 S Holly St, Greentree, Medford, OR 97501-3113 | 2006-09-24 |
| 1518564434 | Melissa Olena Zivanov | Counselor | 140 S Holly St, Medford, OR 97501-3113 | 2020-10-04 |
| 1508483405 | Justin Karl Sacco | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2020-06-26 |
| 1487279402 | Autumn Jewel Doshier | Counselor | 140 S Holly St, Medford, OR 97501-3113 | 2020-06-15 |
| 1275156564 | Mayela Villa | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2020-05-21 |
| 1801435243 | Jeanelle Kline | Counselor | 140 S Holly St, Medford, OR 97501-3113 | 2020-01-02 |
| 1255983979 | Griselda C Veloz | Nurse's Aide | 140 S Holly St, Medford, OR 97501-3113 | 2019-07-12 |
| 1164084497 | Martha Griselda Rodriguez | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2019-07-08 |
| 1083179121 | Anthony Kahaly | Counselor | 140 S Holly St, Medford, OR 97501-3113 | 2019-02-03 |
| 1457820953 | Stephanie Ann Gurczynski | Counselor | 140 S Holly St, Medford, OR 97501-3113 | 2018-11-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265073282 | Brandon Wade Orr | Peer Specialist | 611 W 11th St Apt 2, Medford, OR 97501-3572 | 2019-10-01 |
| 1558829358 | Robert Crawford | Peer Specialist | 221 W Main St # B13, Medford, OR 97501-2728 | 2019-03-11 |
| 1063977858 | Hayley Jo Burns | Peer Specialist | 1362 Garfield St, Medford, OR 97501-3979 | 2019-02-05 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1902288871 | Kelly Burrows | Peer Specialist | 817 N Central Ave, Suite C, Medford, OR 97501-5840 | 2015-06-26 |
| 1609493873 | Heather Marie Getz | Peer Specialist | 200 Beatty St, Medford, OR 97501-5811 | 2020-07-02 |
| 1508483405 | Justin Karl Sacco | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2020-06-26 |
| 1275156564 | Mayela Villa | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2020-05-21 |
| 1427686021 | Richard Joseph Mccleary | Peer Specialist | 200 Beatty St, Medford, OR 97501-5811 | 2020-03-30 |
| 1093358194 | Leticia Parra Aguilar | Peer Specialist | 1003 E Main St Ste 104, Medford, OR 97504-7140 | 2019-10-21 |
| 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.