SANTIAM MOBILE MEDICINE LLC


Address: 1025 2nd St Nw, Salem, OR 97304-4001
Phone: 5035075356

SANTIAM MOBILE MEDICINE LLC (NPI# 1750899035) 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) 1750899035
Entity Type Organization
Organization Name SANTIAM MOBILE MEDICINE LLC
Practice Address 1025 2nd St Nw
Salem
OR 97304-4001
Mailing Address Po Box 63
Sublimity
OR 97385-0063
Practice Telephone 5035075356
Mailing Telephone 5035075356
Mailing Fax Number 4695651273
Enumeration Date 2018-01-20
Last Update Date 2020-07-01
Authorized Official Name CASEY LULAY (MEMBER)
Authorized Official Telephone 5035075356
Authorized Official Credential MSN, FNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR 500673258 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
7657 Sherman Rd Se, Aumsville, OR 973259529 5035075356

Other Data Sources

Entity Type Entity Name Entity Address
Oregon Corporations, Companies and Business Names SANTIAM MOBILE MEDICINE LLC 1025 2nd St Nw, Salem, OR 97304

Office Location

Street Address 1025 2ND ST NW
City SALEM
State OR
Zip Code 97304-4001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619421591 Logan Walters Physical Therapist 1025 2nd St Nw, Salem, OR 97304 2016-08-09
1326684135 Heart and Soul Wellness Clinic LLC Clinic/Center 1025 2nd St Nw, Salem, OR 97304-4001 2019-11-27
1386280220 Compassion Care Family Practice LLC Family Medicine 1025 2nd St Nw, Salem, OR 97304-4001 2019-11-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114413010 Sam Mackenzie Lane Massage Therapist 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 2018-07-03
1144761131 Rachel E Carson Physical Therapist 1025 2nd St. Nw, West Salem, OR 97304 2017-03-10
1962951061 Lee Ann Nail Social Worker 3965 Gibson Rd Nw, Salem, OR 97304 2016-09-29
1770941338 Tysandra Gillis Massage Therapist 859 Mule Deer St., Salem, OR 97304 2016-02-10
1144620295 Molly Rodden Nurse Practitioner 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 2014-08-26
1881942126 Cynthia Ruth Rettler Registered Nurse 1520 Plaza St Nw Ste 150, Salem, OR 97304 2012-08-16
1336401017 Trillium Family Services Community/Behavioral Health 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 2012-06-08
1033428198 Kathleen Ketelson Nurse Practitioner 560 Wallace Rd Nw Ste 140, Salem, OR 97304 2010-10-06
1922332535 Robert Scott Mcadam Social Worker 1245 Edgewater St. Nw, Salem, OR 97304 2009-09-29
1992932560 Michelle Lynn Laseter Counselor 290 Moyer Ln. Nw, Salem, OR 97304 2009-06-22
Find all providers in zip 97304

Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134759012 Caleb James Calder Nurse Practitioner 11 Oakland St, Salem, MA 01970-1520 2020-01-20
1467928184 Jean David Thomas Nurse Practitioner Salem Family Health Center, 47 Congress Street, Salem, MA 01970 2018-10-20
1407371388 Debra Lee Jenkins Nurse Practitioner 1905 Mcvitty Rd, Salem, VA 24153-7405 2017-08-11
1003282310 Rachell Renee Davis Nurse Practitioner 1793 13th St. Se, Salem, OR 97302 2015-08-20
1194108365 Danielle Marlene Dupuis Nurse Practitioner 810 Commercial St Se, Salem, OR 97302 2015-07-06
1306272471 Josh Hooton Nurse Practitioner 251 W State Road 198 Ste 3, Salem, UT 84653-5608 2013-09-20
1104082197 Richard Fredrick Meyers Nurse Practitioner 670 Hawthorne Ave Se, Suite 160, Salem, OR 97301-6884 2008-07-30
1831398122 Karlen E Luthy Nurse Practitioner 118 N Main St Ste B, Salem, UT 84653-5698 2007-07-16
1174603401 Anthony G Haralabatos Nurse Practitioner 59 Stiles Rd 104, Salem, NH 03079-5816 2006-10-17
1457378044 Robert M Wilkinson Nurse Practitioner 141 Hospital Dr Ste 103, Salem, KY 42078-8043 2006-07-17
Find all providers in SALEM

Competitor

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City SALEM
Zip Code 97304

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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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