DR. DEREK KOLLER


Address: 6861 Lemongrass Loop Se, Salem, OR 97306-1474
Phone: 3619024789

DR. DEREK KOLLER (NPI# 1629338470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629338470
Entity Type Individual
Full Name DR. DEREK KOLLER
Credential M.D.
Practice Address 6861 Lemongrass Loop Se
Salem
OR 97306-1474
Practice Telephone 3619024789
Practice Fax Number 3619024588
Mailing Telephone 3619024789
Mailing Fax Number 3619024588
Enumeration Date 2012-05-25
Last Update Date 2020-01-13
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine 036151000 IL Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine ME142837 FL Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine S2376 TX Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine 55553 AZ Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine 17828 NV Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine 11453A WY Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine M-14141 ID Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine MD2018-016 NM Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine MD186008 OR Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine MD60818224 WA Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine DR.0059780 CO Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine MED-PHYS-L MT Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine 284778 NY Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine A143337 CA Allopathic & Osteopathic Physicians
Y 207Q00000X Family Medicine 17981 HI Allopathic & Osteopathic Physicians

Office Location

Street Address 6861 LEMONGRASS LOOP SE
City SALEM
State OR
Zip Code 97306-1474

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134609050 Andrea P Merryman Dental Assistant 5135 Skyline Rd South, Salem, OR 97306 2018-08-20
1215470315 Anthony Quoc Ngo Nurse Practitioner 5050 Skyline Village Loop, Salem, OR 97306 2016-11-22
1134521305 Wendy Poling Occupational Therapy Assistant 1966 Madras St Se Apt 1082, Salem, OR 97306 2014-09-19
1659601045 Monarch Medical Group LLC Clinic/Center 5686 Commercial St Se, Suite 100, Salem, OR 97306 2010-01-06
1316188006 Judith A Mitchell Physician Assistant 4999 Skyline Rd. S., Salem, OR 97306 2009-03-10
1164685574 Leon Chira Pharmacist 2431 Concomly Rd S, Salem, OR 97306 2008-07-07
1912175035 Salem Clinic, PC General Practice 2531 Boone Road Se, Salem, OR 97306 2008-02-11
1326257486 Robert Allen Long Physical Therapist 6250 Commercial St N.e., Salem, OR 97306 2007-05-22
1922137504 Charlene Garbutt Dental Assistant 5135 Skyline Rd. S., Salem, OR 97306 2007-03-02
1417085747 Michelle West Dental Assistant 5135 Skyline R S, Salem, OR 97306 2007-02-28
Find all providers in zip 97306

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710373444 Larry Bassinger Family Medicine 1300 Broadway St Ne Ste 104, Salem, OR 97301-1420 2015-04-09
1396144507 Constance Johanson Family Medicine 3959 Croisan Creek Rd S, Salem, OR 97302-9474 2014-08-14
1457792699 Sultan Seretis Bussey Hospitalist LLC Family Medicine 310 Route 45, Salem, NJ 08079-2064 2013-07-16
1962712927 Paul Julian Perrin Family Medicine 525 Ferry St Se, Suite 203, Salem, OR 97301 2010-10-08
1326372558 Robert Verne Bain Family Medicine 2280 Kuebler Road, South, Salem, OR 97302 2009-09-21
1902036320 James A. Auerbach, M.d., P.C. Family Medicine 4747 Skyline Rd S, Suite 190, Salem, OR 97306-4200 2009-07-20
1033347430 Jeanette Walker Family Medicine 5560 Witzel Rd Se, Salem, OR 97317-9142 2009-06-24
1871747188 Carmelle Marie Andrine Constant Family Medicine 84 Highland Ave Ste 309, Salem, MA 01970-2733 2008-11-13
1518127927 Mazen I Madhoun Family Medicine 3737 W Main St Ste 101, Salem, VA 24153-2073 2008-06-10
1295918910 Michael W Kelber Md PC Family Medicine 2365 Grear St Ne, Salem, OR 97301-2747 2007-12-17
Find all providers in SALEM

Competitor

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City SALEM
Zip Code 97306

Improve Information

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Dataset Information

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.

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