SISTERS OF PROVIDENCE IN OREGON (NPI# 1881770808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881770808 |
| Entity Type | Organization |
| Organization Name | SISTERS OF PROVIDENCE IN OREGON |
| Other Organization Name | PMG SOUTH SHADY COVE |
| Practice Address |
25 Erickson Avenue Shady Cove OR 97539 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5418783730 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2008-04-11 |
| Authorized Official Name | JOHN JACKSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5417326000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | SISTERS OF PROVIDENCE IN OREGON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 288483 | 05 | |
| OR | RAIL ROAD MEDICARE | CG6801 | 01 |
| Other Name | Type Code |
|---|---|
| PMG SOUTH SHADY COVE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568689701 | Sisters of Providence In Oregon | Clinic/Center | 940 Royal Ave, Suite 450, Medford, OR 97504-6193 | 2007-04-19 |
| 1134206790 | Sisters of Providence In Oregon | Clinic/Center | 725 N 5th St, Suite 101, Jacksonville, OR 97530-9873 | 2006-11-01 |
| Street Address |
25 ERICKSON AVENUE |
| City | SHADY COVE |
| State | OR |
| Zip Code | 97539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902421811 | John Paul Hurd | Chiropractor | 21885 Or62, Shady Cove, OR 97539 | 2020-06-16 |
| 1811488851 | Shady Cove Chiropractic and Massage, LLC | Chiropractor | 21885 Or-62, Shady Cove, OR 97539 | 2018-05-25 |
| 1427444264 | Philip Broesamle | Counselor | 60 Mallory Ln., Shady Cove, OR 97539 | 2015-04-08 |
| 1285060772 | Neil Dale Arnspiger | Behavioral Analyst | 159 Train Lane, Shady Cove, OR 97539 | 2013-09-17 |
| 1285952101 | Dan Dale Kelly | Driver | 120 Birch St, Shady Cove, OR 97539 | 2010-05-17 |
| 1104089309 | Kelly Clayton Fnp Inc | Clinic/Center | 387 Pinetop Terrace, Shady Cove, OR 97539 | 2008-07-08 |
| 1285786525 | Robert Russell Bennett | Chiropractor | 21885 Highway 62, Shady Cove, OR 97539 | 2007-01-17 |
| 1053424622 | Phillip Bruce Lassen | Dentist | 21978 Hwy 62, Shady Cove, OR 97539-1236 | 2006-08-16 |
| 1922249382 | David Lee Thompson | Physical Therapy Assistant | 20 Laurel Dr, Shady Cove, OR 97539-3602 | 2009-03-16 |
| 1750861431 | Casey Dean Clingan | Dentist | 21300 Highway 62, Shady Cove, OR 97539-7707 | 2018-08-21 |
| Find all providers in zip 97539 | ||||
| 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 |
|---|---|---|---|---|
| 1932715935 | J.w. Smith, D.c., LLC | Clinic/Center | 4747 S 6th St Ste 2, Klamath Falls, OR 97603-4993 | 2020-09-16 |
| 1427662204 | Edmund H. Torkelson Do, PC | Clinic/Center | 1960 Nw 167th Pl Ste 204, Beaverton, OR 97006-4804 | 2020-08-31 |
| 1134746589 | Redmond Veterinary Clinic PC | Clinic/Center | 1785 Nw 6th St, Redmond, OR 97756-1204 | 2020-07-01 |
| 1801413240 | Gfm LLC | Clinic/Center | 1235 Se Division St Ste 114, Portland, OR 97202-1042 | 2020-07-01 |
| 1184240277 | Evans & Company Healthcare PC | Clinic/Center | 2330 Morada Ln, Ashland, OR 97520-3641 | 2020-06-24 |
| 1427674324 | Northwest Pain Institute | Clinic/Center | 2005 Cedar St, Forest Grove, OR 97116-1701 | 2020-06-17 |
| 1275168759 | Metatron Health LLC | Clinic/Center | 6464 Sw Borland Rd Ste C3, Tualatin, OR 97062-8856 | 2020-03-05 |
| 1427680057 | Ortc, LLC | Clinic/Center | 750 Biddle Rd Ste 102, Medford, OR 97504-6178 | 2020-02-11 |
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1861038382 | Clackamas County | Clinic/Center | 2051 Kaen Rd Ste 210, Oregon City, OR 97045-4035 | 2019-11-19 |
| Find all providers with the same taxonomy | ||||
| City | SHADY COVE |
| Zip Code | 97539 |
Please comment or provide details below to improve the information on SISTERS OF PROVIDENCE IN OREGON.
| 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.