SALEM OR OPHTHALMOLOGY ASC LLC (NPI# 1811962103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811962103 |
| Entity Type | Organization |
| Organization Name | SALEM OR OPHTHALMOLOGY ASC LLC |
| Other Organization Name | SALEM LASER & SURGERY CENTER |
| Practice Address |
1330 Commercial St Se Salem OR 97302-4206 |
| Mailing Address |
1a Burton Hills Blvd Nashville TN 37215-0000 |
| Practice Telephone | 5037631973 |
| Practice Fax Number | 5037638886 |
| Mailing Telephone | 6156651283 |
| Mailing Fax Number | 6152341720 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2014-09-03 |
| Authorized Official Name | MR. PHILLIP A CLENDENIN (PRESIDENT) |
| Authorized Official Telephone | 6156651283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
07-1574 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 005857 | 05 |
| Other Name | Type Code |
|---|---|
| Salem Laser & Surgery Center | Doing Business As Name - Organization |
| Street Address |
1330 COMMERCIAL ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574066 | Kimberly Ann Johnson | Registered Nurse | 1330 Commercial St Se, Salem, OR 97302-4206 | 2015-12-17 |
| 1760405559 | Mary Ann Leofsky Robbins | Nurse Anesthetist, Certified Registered | 1330 Commercial St Se, Salem, OR 97302 | 2006-07-25 |
| 1861410078 | Jeffrey Lockwood | Nurse Anesthetist, Certified Registered | 1330 Commercial St Se, Salem, OR 97302-4206 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548784556 | North Atlantic Surgical Suites, LLC | Clinic/Center | 23 Keewaydin Dr, Salem, NH 03079-2840 | 2017-08-01 |
| 1972902286 | Oregon Specialists Surgery Center LLC | Clinic/Center | 2785 River Rd S, Salem, OR 97302-5883 | 2014-08-22 |
| 1952567257 | Salem Surgical Services | Clinic/Center | 2360 Southeast Blvd, Salem, OH 44460-3418 | 2008-08-06 |
| 1912045154 | Croisan Ridge Surgery Center, LLC | Clinic/Center | 4999 Skyline Rd S # 150, Salem, OR 97306-2009 | 2007-02-01 |
| 1932256278 | The Surgery Center of Salem County LLC | Clinic/Center | 336 Woodstown Rd., Salem, NJ 08079 | 2007-01-05 |
| 1285725713 | The Surgery Center of Salem County LLC | Clinic/Center | 336 Woodstown Rd, Salem, NJ 08079 | 2006-09-28 |
| 1619933264 | Salem Surgery Center, LLC | Clinic/Center | 2525 12st Se, Suite 110, Salem, OR 97302 | 2006-04-23 |
| 1538146931 | Willamette Surgery Center LLC | Clinic/Center | 1445 State St, Salem, OR 97301-4248 | 2005-12-27 |
| 1023005139 | Roanoke Valley Center for Sight LLC | Clinic/Center | 438 W Main St, Salem, VA 24153-3610 | 2005-10-04 |
| 1881694792 | Willamette Spine Center Ambulatory Surgery LLC | Clinic/Center | 2480 Liberty St Ne, Suite 120, Salem, OR 97303-6780 | 2005-07-21 |
| Find all providers in SALEM | ||||
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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.