SOUTHERN OREGON CARDIOLOGY LLC (NPI# 1033444781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033444781 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OREGON CARDIOLOGY LLC |
| Practice Address |
520 Medical Center Dr Ste 200 Medford OR 97504-4314 |
| Practice Telephone | 5412826600 |
| Practice Fax Number | 5412826601 |
| Mailing Telephone | 5412826600 |
| Mailing Fax Number | 5412826601 |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2012-05-04 |
| Authorized Official Name | MR. RICHARD BODAGER (CEO) |
| Authorized Official Telephone | 5417895600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
1000026501 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
520 MEDICAL CENTER DR STE 200 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-4314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922095199 | Joel A Tobias | Internal Medicine | 520 Medical Center Dr, Suite 200, Medford, OR 97504-4314 | 2005-10-04 |
| 1033588546 | Daniel Neville | Physician Assistant | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2015-09-15 |
| 1063855161 | App Cardiovascular Surgeons | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2013-04-09 |
| 1205180098 | Stephani Kathleen Cook | Physician Assistant | 520 Medical Center Dr, Suite 300, Medford, OR 97504-4334 | 2012-11-01 |
| 1790014074 | Christopher Charles Davis | Physician Assistant | 520 Medical Center Dr, Suite 300, Medford, OR 97504-4334 | 2009-12-15 |
| 1104056092 | Dani J Thomas | Internal Medicine | 520 Medical Center Dr, Suite 2001, Medford, OR 97504-4334 | 2009-07-26 |
| 1265675599 | Natalie E Baxter | Physician Assistant | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4334 | 2009-04-16 |
| 1629267414 | Pamela Reeger Cortell | Nurse Practitioner | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2007-10-17 |
| 1144412529 | Patrick Joseph Phelan | Surgery | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2007-08-09 |
| 1457555237 | Mitchell Martin Plummer | Surgery | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2007-06-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1669511945 | Minor Edwin Matthews | Internal Medicine | 271 Island Pointe Dr, Medford, OR 97504-9453 | 2007-02-05 |
| 1922010719 | Inderjit Katyal | Internal Medicine | 74 Southaven Ave, Medford, NY 11763-3746 | 2006-08-12 |
| 1386609238 | Michael J Zema | Internal Medicine | 844 Golf Ln, Medford, NY 11763-1203 | 2006-04-20 |
| 1376517532 | David Samenuk | Internal Medicine | 137 Main St, Medford, MA 02155 | 2006-02-15 |
| 1922095199 | Joel A Tobias | Internal Medicine | 520 Medical Center Dr, Suite 200, Medford, OR 97504-4314 | 2005-10-04 |
| 1487650586 | Christopher E Cannon | Internal Medicine | 1698 E. Mcandrews Rd, Suite 300, Medford, OR 97504-5590 | 2005-06-23 |
| 1457649626 | Keval K Patel | Internal Medicine | 520 Medical Center Dr Ste 200, Medford, OR 97504-4314 | 2011-07-21 |
| 1043337439 | Melike Arslan | Internal Medicine | 1698 E Mcandrews Rd, Suite 300, Medford, OR 97504-5589 | 2007-03-23 |
| 1023165925 | Donald L Bowser | Internal Medicine | 520 Medical Center Dr, Suite 100, Medford, OR 97504-4334 | 2007-01-04 |
| 1093827883 | Jaekyoung Audrey Hong | Internal Medicine | 520 Medical Center Dr, Suite 200, Medford, OR 97504-4314 | 2006-08-31 |
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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.