ROSEBURG HEART ASSOCIATES PC (NPI# 1730308529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730308529 |
| Entity Type | Organization |
| Organization Name | ROSEBURG HEART ASSOCIATES PC |
| Practice Address |
2700 Nw Stewart Pkwy Suite 200 Roseburg OR 97470-1281 |
| Practice Telephone | 5416776521 |
| Mailing Telephone | 5416776521 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-10-30 |
| Authorized Official Name | FREDERIC J VAN DIS (PRESIDENT) |
| Authorized Official Telephone | 5416776521 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD12356 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
2700 NW STEWART PKWY SUITE 200 |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97470-1281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790766822 | Mercy Healthcare, Inc | General Acute Care Hospital | 2700 Nw Stewart Pkwy, Roseburg, OR 97470-1281 | 2005-11-07 |
| 1902412505 | Lisa Mai | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1214 | 2020-09-18 |
| 1609480359 | Jacob Watters | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2020-09-01 |
| 1245843143 | Marcus Lee David Sickelton | Student in an Organized Health Care Education/Training Program | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1214 | 2020-08-28 |
| 1053978403 | Shelli Cross | Registered Nurse | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2019-05-21 |
| 1225695711 | Christa Lynne Creech | Pharmacist | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2019-05-21 |
| 1366007510 | Nikki Jean Whiting | Nurse Practitioner | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2019-05-03 |
| 1629554811 | Gary Sorcher | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-11 |
| 1548756158 | Timothy Lawrence Garvey Jr. | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-06 |
| 1437645223 | Kimberly Ann Romano | Registered Nurse | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
| 1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
| 1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
| 1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
| 1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
| 1700282415 | Samantha Marie Shelley | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2014-11-06 |
| 1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
| 1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
| 1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
| 1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
| Find all providers in zip 97470 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518103274 | Centennial Medical Group Inc. | Internal Medicine | 201 Nw Medical Loop Ste 190, Roseburg, OR 97471-8835 | 2008-12-31 |
| 1497820583 | Frances C Munkenbeck Md PC | Internal Medicine | 2700 Nw Stewart Parkway 200, Roseburg, OR 97470 | 2006-11-22 |
| 1639275712 | Lifetime Health Clinic | Internal Medicine | 868 Northwest Garden Valley Boulevard, Roseburg, OR 97470-1959 | 2006-09-15 |
| 1841294774 | Douglas Edward Anderson | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2005-06-09 |
| 1417225939 | Ibrahim Osman | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471 | 2011-12-12 |
| 1285753160 | Courtney Rae Virgilio | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2007-03-29 |
| 1932284528 | Gary Bronstein | Internal Medicine | 2801 Nw Mercy Dr, Suite 300, Roseburg, OR 97471-2348 | 2006-10-25 |
| 1083703078 | Cynthia Brownson Kremser | Internal Medicine | 489 Cherokee Ave, Roseburg, OR 97470-9534 | 2006-10-11 |
| 1992728760 | Leslie Vernor Walker | Internal Medicine | 913 Nw Garden Valley Blvd, Roseburg, OR 97470-6523 | 2006-07-25 |
| 1093786261 | Frederic J Van Dis | Internal Medicine | 2801 Nw Mercy Dr, Ste. 300, Roseburg, OR 97471 | 2006-01-27 |
| Find all providers in ROSEBURG | ||||
Please comment or provide details below to improve the information on ROSEBURG HEART ASSOCIATES PC.
| 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.