MT. TABOR FAMILY MEDICAL GROUP, P.C. (NPI# 1548416944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548416944 |
Entity Type | Organization |
Organization Name | MT. TABOR FAMILY MEDICAL GROUP, P.C. |
Practice Address |
5919 Se Belmont St Portland OR 97215-1925 |
Mailing Address |
5810 Nancy Ridge Dr 100 San Diego CA 92121-2834 |
Practice Telephone | 5032347366 |
Enumeration Date | 2008-08-18 |
Last Update Date | 2010-07-02 |
Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
Authorized Official Telephone | 8586252990 |
Is Organization Subpart | Y |
Parent Organization Name | MEDVANTX, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332900000X | Non-Pharmacy Dispensing Site | MD12668 | OR | Suppliers |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | MT. TABOR FAMILY MEDICAL GROUP, P.C. | 5919 Se Belmont St, Portland, OR 97215 |
Street Address |
5919 SE BELMONT ST |
City | PORTLAND |
State | OR |
Zip Code | 97215-1925 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316929870 | Susan Wade Cato | Nurse Practitioner | 5919 Se Belmont St, Portland, OR 97215-1925 | 2005-11-18 |
1699968784 | Anna Urbanc | Physician Assistant | 5919 Se Belmont St, Portland, OR 97215-1925 | 2007-08-22 |
1659468080 | Mt. Tabor Family Medical Group, PC | Clinic/Center | 5919 Se Belmont St, Portland, OR 97215-1925 | 2006-10-06 |
1598744971 | Tedd Levin | Family Medicine | 5919 Se Belmont St, Portland, OR 97215-1925 | 2006-01-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
Find all providers in zip 97215 |
Taxonomy Code | 332900000X |
Grouping | Suppliers |
Classification | Non-Pharmacy Dispensing Site |
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154931814 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 6910 Se Milwaukie Ave, Portland, OR 97202-5717 | 2020-08-06 |
1902416175 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 8179 N Lombard St, Portland, OR 97203-3130 | 2020-08-03 |
1144830365 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 945 Nw Lovejoy St, Portland, OR 97209-3475 | 2020-08-03 |
1174133300 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 7855 Sw Capitol Hwy, Portland, OR 97219-2465 | 2020-08-03 |
1386254514 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 3872 N Mississippi Ave, Portland, OR 97227-1161 | 2020-08-03 |
1407466865 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 3218 Ne Broadway St, Portland, OR 97232-1815 | 2020-07-31 |
1437768066 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 2400 E Burnside St, Portland, OR 97214-1752 | 2020-07-29 |
1447869060 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 3150 Se Division St, Portland, OR 97202-1172 | 2020-07-29 |
1699385401 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 172 Ne Martin Luther King Jr Blvd, Portland, OR 97232-2943 | 2020-08-06 |
1821608514 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 607 Ne Grand Ave, Portland, OR 97232-2728 | 2020-08-06 |
Find all providers in PORTLAND |
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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.