MCKENZIE WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES LLC (NPI# 1528006301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528006301 |
| Entity Type | Organization |
| Organization Name | MCKENZIE WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES LLC |
| Other Organization Name | MCKENZIE-WILLAMETTE MEDICAL CENTER |
| Practice Address |
1460 G St Springfield OR 97477-4112 |
| Practice Telephone | 5417264401 |
| Practice Fax Number | 5417264540 |
| Mailing Telephone | 5417264401 |
| Mailing Fax Number | 5417264540 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | REBECCA HURLEY (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 2144737000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| X | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 246W00000X | Technician, Cardiology | Technologists, Technicians & Other Technical Service Providers | ||
| X | 246X00000X | Spec/Tech, Cardiovascular | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 232828 | 05 |
| Other Name | Type Code |
|---|---|
| McKenzie-Willamette Medical Center | Doing Business As Name - Organization |
| Street Address |
1460 G ST |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97477-4112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306846399 | Kyong Min Yi | Surgery | 1460 G St, Springfield, OR 97477-4112 | 2005-07-30 |
| 1902411424 | Samantha Gillespie | Nurse Practitioner | 1460 G St, Springfield, OR 97477-4112 | 2020-09-11 |
| 1942812219 | Christian Elizabeth Ross | Nurse Practitioner | 1460 G St, Springfield, OR 97477-4112 | 2020-08-18 |
| 1275150260 | Tara Kruse | Physician Assistant | 1460 G St, Springfield, OR 97477-4112 | 2020-06-25 |
| 1265079701 | Madeleine Rose Bell | Physician Assistant | 1460 G St, Springfield, OR 97477-4112 | 2019-12-03 |
| 1568017028 | Karen M Booth | Dietitian, Registered | 1460 G St, Springfield, OR 97477-4112 | 2019-08-01 |
| 1740764943 | Kristen Kellogg | Physician Assistant | 1460 G St, Springfield, OR 97477-4112 | 2018-09-24 |
| 1992289698 | Michael Moore | Physician Assistant | 1460 G St, Springfield, OR 97477-4112 | 2018-09-18 |
| 1881175206 | Marisa Drazek | Physician Assistant | 1460 G St, Springfield, OR 97477-4112 | 2018-08-23 |
| 1427546712 | Kathleen M Gates | Dietitian, Registered | 1460 G St, Springfield, OR 97477-4112 | 2018-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
| 1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
| 1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
| 1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
| 1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
| 1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
| Find all providers in zip 97477 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366905523 | Premier Cardiac and Vascular LLC | Internal Medicine | 5514 Alma Ln Ste 200, Springfield, VA 22151-4014 | 2019-04-12 |
| 1760820930 | Shady Henien | Internal Medicine | 800 E Carpenter St # 62, Springfield, IL 62769-1000 | 2013-06-11 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1669784781 | Clifford Eugene Schott Jr. | Internal Medicine | 531 W Woodland Ave, Springfield, PA 19064-1646 | 2010-07-06 |
| 1730406760 | Joseph James Marmora | Internal Medicine | 211 Mountain Avenue, Associates In Cardiovascular Disease, Springfield, NJ 07081 | 2010-04-30 |
| 1083858310 | Brian Scott Wasserman | Internal Medicine | 3300 Main St Fl 2, Springfield, MA 01107-1112 | 2009-04-30 |
| 1104085505 | Sujata Holman | Internal Medicine | 2 Medical Center Dr Ste 410, Springfield, MA 01107-1273 | 2008-06-02 |
| 1932396157 | Centrum Cardiology, Ltd | Internal Medicine | 319 E Madison St Ste 2d, Springfield, IL 62701-3120 | 2007-10-02 |
| 1386858876 | Allen B. Weisse | Internal Medicine | 164 Hillside Ave, Springfield, NJ 07081-2808 | 2007-05-10 |
| 1467541433 | David S. Cochran | Internal Medicine | 2115 S Fremont Ave Ste 4300, Springfield, MO 65804-2232 | 2006-10-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97477 |
Please comment or provide details below to improve the information on MCKENZIE WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES LLC.
| 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.