WVP MEDICAL GROUP, LLC (NPI# 1831504968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831504968 |
| Entity Type | Organization |
| Organization Name | WVP MEDICAL GROUP, LLC |
| Other Organization Name | WVP MEDICAL GROUP- BOULDER CREEK |
| Practice Address |
2485 12th St. Se Salem OR 97302-0000 |
| Practice Telephone | 5033638047 |
| Practice Fax Number | 5033636571 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2014-06-27 |
| Authorized Official Name | MR. DEAN ANDRETTA (CFO) |
| Authorized Official Telephone | 5033717701 |
| Is Organization Subpart | Y |
| Parent Organization Name | MID VALLEY IPA, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WVP Medical Group- Boulder Creek | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922583616 | Wvp Medical Group, LLC | Clinic/Center | 2995 Ryan Dr Se Ste 200, Salem, OR 97301-5157 | 2018-09-27 |
| 1982148789 | Wvp Medical Group, LLC | Internal Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2016-12-13 |
| 1538535059 | Wvp Medical Group, LLC | Clinic/Center | 1430 Monmouth St, Independence, OR 97351-1127 | 2015-08-19 |
| 1710231550 | Wvp Medical Group, LLC | Family Medicine | 2365 Grear St Ne, Salem, OR 97301-2747 | 2012-11-01 |
| 1518225242 | Wvp Medical Group, LLC | Clinic/Center | 1155 Mission St Se, Suite 205, Salem, OR 97302-6228 | 2012-05-01 |
| 1164780060 | Wvp Medical Group, LLC | Clinic/Center | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2012-04-27 |
| 1538459938 | Wvp Medical Group, LLC | Clinic/Center | 2478 13th St Se, Ste. 200, Salem, OR 97302-2546 | 2011-04-19 |
| 1750684767 | Wvp Medical Group, LLC | Clinic/Center | 5100 River Rd N, Keizer, OR 97303-5371 | 2010-12-13 |
| 1124352877 | Wvp Medical Group, LLC | Family Medicine | 2485 12th St Se, Salem, OR 97302-2151 | 2009-09-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WVP MEDICAL GROUP, LLC | 245 Commercial St Se Ste 200, Salem, OR 97301 |
| Street Address |
2485 12TH ST. SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-0000 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063069300 | Ideal Option Pllc | Clinic/Center | 863 Liberty St Ne, Salem, OR 97301-2451 | 2019-08-21 |
| 1326589771 | Saint Moscati Community Health Care | Clinic/Center | 4131 Glendale Ave Ne, Salem, OR 97305-1913 | 2017-03-18 |
| 1275983660 | Salem Community Acupuncture Project | Clinic/Center | 2416 13th St Se, Salem, OR 97302-2546 | 2016-06-15 |
| 1619341633 | Hkd Treatment Options | Clinic/Center | 84 Highland Ave., Suite 305, Salem, MA 01970 | 2015-11-16 |
| 1770967325 | Dancing Crane Center of Chinese Medicine | Clinic/Center | 11 Library Sq, Salem, VA 24153-3846 | 2015-07-14 |
| 1013210095 | Salem Occupational and Acute Care | Clinic/Center | 13 Red Roof Ln Ste 2, Salem, NH 03079-2983 | 2010-12-13 |
| 1336456516 | Salem Free Medical Clinic | Clinic/Center | 1300 Broadway St Ne Suite #104, Salem, OR 97301 | 2010-09-09 |
| 1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
| 1659524403 | Doctor's Diagnositcs, LLC | Clinic/Center | 322 Highway 62 W, Suite 2, Salem, AR 72576-9566 | 2008-10-24 |
| 1881840882 | Dr. Alton Rossman & Associates, Inc. | Clinic/Center | 1594 Edgewater St Nw Ste 190, Salem, OR 97304-4656 | 2008-08-11 |
| 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.