CRATER LAKE SURGERY CENTER LLC (NPI# 1679939318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679939318 |
| Entity Type | Organization |
| Organization Name | CRATER LAKE SURGERY CENTER LLC |
| Practice Address |
833 Bennett Ave Medford OR 97504-6715 |
| Mailing Address |
825 Bennett Ave Medford OR 97504-6715 |
| Practice Telephone | 5417795228 |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2018-06-18 |
| Authorized Official Name | DR. JOSEPH SAVINO (MEMBER) |
| Authorized Official Telephone | 5417795228 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 835 Bennett Ave, Medford, OR 975046715 | 5417795228 |
| Street Address |
833 BENNETT AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073149365 | Medford Surgery Center, LLC | Clinic/Center | 170 Governors Ave Ste 100, Medford, MA 02155-1643 | 2020-03-18 |
| 1528016656 | Vantage Surgical Associates, LLC | Clinic/Center | 180 Route 70, Medford, NJ 08055 | 2006-05-04 |
| 1841286267 | Surgery Center of Southern Oregon, LLC | Clinic/Center | 2798 E Barnett Rd, Medford, OR 97504-8343 | 2005-09-21 |
| 1932657145 | Cherry Hill Asc LLC | Clinic/Center | 180 Route 70, Medford, NJ 08055-8703 | 2016-09-16 |
| 1982008975 | Surgical Pain Solutions LLC | Clinic/Center | 701 Golf View Dr, Medford, OR 97504 | 2014-10-20 |
| 1124396544 | Valley Plastic Surgery, LLC | Clinic/Center | 1170 Royal Ave, Medford, OR 97504-6101 | 2011-12-13 |
| 1508143330 | Earl H Parrish Md PC | Clinic/Center | 701 Golf View Dr, Medford, OR 97504-9643 | 2011-11-08 |
| 1275821746 | Oregon Ear Nose and Throat Surgery | Clinic/Center | 920 Royal Ave, Medford, OR 97504-6169 | 2011-07-18 |
| 1336479021 | Rogue Valley Surgery Center LLC | Clinic/Center | 2925 Siskiyou Blvd, Medford, OR 97504-8179 | 2010-01-03 |
| 1811196900 | Earl H. Parrish, M.d., P.C. | Clinic/Center | 701 Golf View Dr, Medford, OR 97504-9643 | 2007-07-17 |
| Find all providers in MEDFORD | ||||
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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.