LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC. (NPI# 1942793583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942793583 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC. |
| Other Organization Name | PHOENIX HEALTH CENTER- LA CLINICA |
| Practice Address |
3617 S Pacific Hwy Medford OR 97501-8957 |
| Mailing Address |
931 Chevy Way Medford OR 97504-4127 |
| Practice Telephone | 5415356239 |
| Practice Fax Number | 5415121026 |
| Mailing Telephone | 5415356239 |
| Mailing Fax Number | 5418422212 |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2019-07-15 |
| Authorized Official Name | TARA LYNETTE JEANNOT (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 5415356239 |
| Is Organization Subpart | Y |
| Parent Organization Name | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Phoenix Health Center | Doing Business As Name - Organization |
| Phoenix Health Center- La Clinica | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540398 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 102 Christian Avenue, Talent, OR 97540 | 2020-08-28 |
| 1790398048 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 307 Wagner Creek Road, Talent, OR 97540 | 2020-08-26 |
| 1184237489 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 1011 La Loma Dr, Medford, OR 97504-8613 | 2020-08-26 |
| 1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
| 1245860048 | La Clinica Del Valle Family Healthcare Center Inc. | Internal Medicine | 910 S Central Ave, Medford, OR 97501-7822 | 2020-01-21 |
| 1134302250 | La Clinica Del Valle Family Healthcare Center Inc. | Counselor | 1307 W Main St, Medford, OR 97501-2936 | 2007-12-12 |
| Street Address |
3617 S PACIFIC HWY |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-8957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437145265 | Brandee Danks | Physician Assistant | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2005-09-27 |
| 1730703380 | Lydia Ruthann Woody | Counselor | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2020-05-29 |
| 1871142562 | Ashleigh Adams | Counselor | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2019-09-05 |
| 1023660099 | La Clinica Del Valle Family Health Care Center Inc. | Pharmacy | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2019-07-10 |
| 1104334820 | Nona Neil | Registered Nurse | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2018-01-16 |
| 1407360241 | Toni Rae Asher | Registered Nurse | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2017-11-30 |
| 1558873547 | Maggie Schein | Registered Nurse | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2017-10-30 |
| 1578080404 | Sierra Gwin | Registered Nurse | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2017-08-22 |
| 1720513690 | Rebecca Holmes | Registered Nurse | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2017-04-27 |
| 1942749833 | Laura Breu | Nurse Practitioner | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2017-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1588622740 | David Ross Salowe | Internal Medicine | 103 Old Marlton Pike Ste 101, Medford, NJ 08055-8772 | 2006-05-03 |
| 1952381394 | Peter W Adesman | Internal Medicine | 2860 Creekside Circle, Medford, OR 97504 | 2006-01-20 |
| 1245860048 | La Clinica Del Valle Family Healthcare Center Inc. | Internal Medicine | 910 S Central Ave, Medford, OR 97501-7822 | 2020-01-21 |
| 1700379419 | La Clinica Del Valle Family Health Care Center Inc. | Internal Medicine | 1307 W Main St, Medford, OR 97501-2936 | 2018-06-08 |
| 1982011813 | Zain Kassam | Internal Medicine | 196 Boston Ave, Suite #1000, Medford, MA 02155-4236 | 2014-07-11 |
| 1558702514 | Vinshi Naz Khan | Internal Medicine | 1698 E Mcandrews Rd Ste 400, Medford, OR 97504-5590 | 2013-07-07 |
| 1821388083 | Meghan E Gilroy | Internal Medicine | 2860 Creekside Cir, Medford, OR 97504 | 2011-04-08 |
| 1144423765 | Angela D. Frates | Internal Medicine | 103 Old Marlton Pike Ste 101, Medford, NJ 08055-8772 | 2007-06-10 |
| 1316011422 | Richard J Hebert | Internal Medicine | 2860 Creekside Cir, Medford, OR 97504 | 2006-11-20 |
| 1215030291 | James A. Kemp | Internal Medicine | 26 City Hall Mall, Medford, MA 02155-4754 | 2006-09-06 |
| Find all providers in MEDFORD | ||||
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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.