MS. VALERIE B LODGE (NPI# 1609123298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609123298 |
| Entity Type | Individual |
| Full Name | MS. VALERIE B LODGE |
| Credential | FNP |
| Practice Address |
1010 1st St Se Suite 110 Bandon OR 97411-9301 |
| Mailing Address |
1010 1st St Se Ste 110 Bandon OR 97411-9301 |
| Practice Telephone | 5413472529 |
| Practice Fax Number | 8885415742 |
| Mailing Telephone | 5413472529 |
| Mailing Fax Number | 8885415742 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2020-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201392459 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2041265 | 05 | |
| OR | 500706882 | 05 |
| Street Address |
1010 1ST ST SE SUITE 110 |
| City | BANDON |
| State | OR |
| Zip Code | 97411-9301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346277027 | Henry H. Holmes | Family Medicine | 1010 1st St Se, Suite 110, Bandon, OR 97411-9301 | 2006-06-27 |
| 1427594977 | Coast Community Health Clinic | Clinic/Center | 1010 1st St Se, Bandon, OR 97411-9301 | 2017-01-09 |
| 1033348289 | Bandon Community Health Center | Clinic/Center | 1010 1st St Se, Bandon, OR 97411-9301 | 2009-07-09 |
| 1639232978 | Laura Franklin | Registered Nurse | 1010 1st St Se, Suite 110, Bandon, OR 97411-9301 | 2006-12-18 |
| 1326151895 | Mariarose M Shanahe | Counselor | 1010 1st St Se, Suite 265, Bandon, OR 97411-9301 | 2006-08-17 |
| 1588699292 | Richard Kelly Staggenborg | Psychiatry & Neurology | 1010 1st St Se, Bandon, OR 97411-9301 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851756340 | Carl John Moehring | Internal Medicine | 2840 Beach Loop Dr. Sw, Bandon, OR 97411 | 2015-12-28 |
| 1841692969 | Bandon Senior Living LLC | Assisted Living Facility | 1000 6th Ave West, Bandon, OR 97411 | 2014-09-19 |
| 1962824821 | Oregon Retina, LLP | Ophthalmology | 1095 Alabama Street, Bandon, OR 97411 | 2014-01-13 |
| 1063756401 | Bandon Coastal Dental, LLC | Clinic/Center | 1097 Baltimore Ave, Bandon, OR 97411 | 2012-11-26 |
| 1114205028 | James Ryan Surface | Dentist | 1275 Oregon Ave., Bandon, OR 97411 | 2011-07-26 |
| 1790083509 | William M. Soper, Dds | Preferred Provider Organization | 1275 Oregon Ave, Bandon, OR 97411 | 2011-03-02 |
| 1285860635 | Sharen C. Strong | Dentist | 155 Delaware Ave, Bandon, OR 97411 | 2009-05-29 |
| 1518158500 | Coos Eye Centers, Inc. | Optometrist | 1095 Alabama Avenue, Bandon, OR 97411 | 2007-08-06 |
| 1043432040 | Michael Brent Currie | Chiropractor | 55416 Melton Road, Bandon, OR 97411 | 2007-05-02 |
| 1619098167 | Susan Lynn Dimock | Social Worker | 1212 Alabama St, Suite 27, Bandon, OR 97411 | 2007-04-03 |
| Find all providers in zip 97411 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952354839 | Ingrid Maria Tyson | Nurse Practitioner | 780 2nd St Se, Bandon, OR 97411-8354 | 2006-05-19 |
| 1841717816 | Whitney Jones Lynn | Nurse Practitioner | 1010 1st St Se Ste 110, Bandon, OR 97411-9301 | 2017-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484631 | Dana Marie Hampton | Nurse Practitioner | 2474 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2020-10-13 |
| 1730796525 | Eden Fair | Nurse Practitioner | 841 E Cascade Ave, Sisters, OR 97759-5014 | 2020-09-25 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1548870306 | Virtual Recovery | Nurse Practitioner | 1038 Heathrow Dr, Eugene, OR 97402-1585 | 2020-08-06 |
| 1174148969 | Martina D Ford | Nurse Practitioner | 9370 Sw Greenburg Rd Ste 200, Tigard, OR 97223-5421 | 2020-06-08 |
| 1134740152 | South Coast Healthcare LLC | Nurse Practitioner | 29641 Ellensburg Ave, Gold Beach, OR 97444-8701 | 2020-04-30 |
| 1124657887 | Shelly Prather | Nurse Practitioner | 350 Wheeler St, Lebanon, OR 97355-4349 | 2020-04-05 |
| 1811521586 | Valorine Tsopmoh Tsopmoh | Nurse Practitioner | 924 Se Sacha Pl, Hillsboro, OR 97123-4685 | 2020-03-02 |
| 1174163356 | Erika Nichole Adams | Nurse Practitioner | 180 Ford Rd., John Day, OR 97845 | 2020-01-15 |
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MS. VALERIE B LODGE.
| 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.