JEFFERY PAUL ROBERTS (NPI# 1578782975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578782975 |
| Entity Type | Individual |
| Full Name | JEFFERY PAUL ROBERTS |
| Credential | PA-C |
| Practice Address |
1460 G St Springfield OR 97477-4112 |
| Practice Telephone | 5417264580 |
| Practice Fax Number | 5417263166 |
| Mailing Telephone | 5417264580 |
| Mailing Fax Number | 5417263166 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
PA00684 | OR | Ambulatory Health Care Facilities |
| N | 363A00000X | Physician Assistant | PA00684 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346757481 | Jeffery W Roberts | Nurse Anesthetist, Certified Registered | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-01-10 |
| 1417180605 | Jeffery Martin Roberts | Counselor | 21123 Smokey Point Blvd, Arlington, WA 98223-4224 | 2009-09-03 |
| 1164588802 | Jeffery A Roberts | Dentist | 5955 S Emerson Ave, Ste. 200, Indianapolis, IN 46237-2600 | 2006-12-28 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790874 | Janice G. Sadaya-conda M.d., Pllc | Clinic/Center | 6128 Brandon Ave Ste 225, Springfield, VA 22150-2640 | 2020-08-12 |
| 1639612880 | Icco LLC | Clinic/Center | 5781 Main Street, Springfield, OR 97478 | 2016-11-21 |
| 1164841912 | Yellow Springs Primary Care, Inc | Clinic/Center | 2608 E High St, Springfield, OH 45505-1454 | 2014-04-09 |
| 1891125480 | Western Massachusetts Primary Care PC | Clinic/Center | 405 Armory St, Springfield, MA 01104-2305 | 2013-11-18 |
| 1629364351 | Spring Valley Family Care | Clinic/Center | 27 Springfield Pike, Springfield, WV 26763 | 2011-06-21 |
| 1881193670 | 417 Health & Wellness | Clinic/Center | 1850 S Stewart Ave, Springfield, MO 65804-2519 | 2018-02-07 |
| 1588057533 | Quest Primary Care LLC | Clinic/Center | 1176 E Home Rd, Springfield, OH 45503-2726 | 2015-03-16 |
| 1851718712 | Community Health Clinic Pllc | Clinic/Center | 80 Congress St, Springfield, MA 01104-3564 | 2014-03-27 |
| 1518309426 | Burton Hills Primary Care, LLC | Clinic/Center | 2662 Memorial Blvd, Springfield, TN 37172 | 2013-07-19 |
| 1922350099 | Board of Trustees of Southern Illinois University | Clinic/Center | 5220 S 6th Street Rd, Suite 1200, Springfield, IL 62703-5735 | 2012-10-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97477 |
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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.