PAUL DOUGLAS REICHERTER (NPI# 1053379826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053379826 |
| Entity Type | Individual |
| Full Name | PAUL DOUGLAS REICHERTER |
| Credential | MD |
| Practice Address |
1813 W Harvard Ave Ste 310 Roseburg OR 97471-2752 |
| Practice Telephone | 5416727546 |
| Practice Fax Number | 5419578446 |
| Mailing Telephone | 5416727546 |
| Mailing Fax Number | 5419578446 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 2015039802 | MO | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
2015039802 | MO | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
2015039802 | MO | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
2015039802 | MO | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
2015039802 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 286785 | 05 | |
| MO | 1053379826 | 05 | |
| OR | CLIA # | 38D1028702 | 01 |
| OR | RAILROAD MEDICARE | DC5977 | 01 |
| OR | BLUE CROSS | 838392000 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2101 Charlotte St, Kansas City, MO 641082727 | 8164047810 | 8164041723 |
| Street Address |
1813 W HARVARD AVE STE 310 |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-2752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780677146 | Laurence M. Sharp | Family Medicine | 1813 W Harvard Ave, Suite 426, Roseburg, OR 97471-2752 | 2005-08-31 |
| 1851954853 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 1813 W Harvard Ave, Suite 241, Roseburg, OR 97471 | 2019-04-16 |
| 1801314372 | Jacob Dean Thompson | Physician Assistant | 1813 W Harvard Ave, #310, Roseburg, OR 97471 | 2017-09-06 |
| 1851828511 | Kimberlly Joy Stevens | Nurse Practitioner | 1813 W Harvard Ave, Suite 241, Roseburg, OR 97471-8708 | 2017-05-12 |
| 1871030338 | Ashley D Heuer | Physician Assistant | 1813 W Harvard Ave, Suite 310, Roseburg, OR 97471-2752 | 2017-01-23 |
| 1619410982 | Tabitha Waller | Nurse Practitioner | 1813 W Harvard Ave, Suite 241, Roseburg, OR 97471-2752 | 2016-11-18 |
| 1780065870 | Umpqua Valley Internists PC | Internal Medicine | 1813 W Harvard Ave, Ste 423, Roseburg, OR 97471-2752 | 2015-06-15 |
| 1679965149 | Joshua J Middlekauff | Nurse Practitioner | 1813 W Harvard Ave, Suite 201, Roseburg, OR 97471-2752 | 2015-02-20 |
| 1144631326 | Community Health Alliance | Community/Behavioral Health | 1813 W Harvard Ave, Ste 448, Roseburg, OR 97471-2752 | 2014-05-09 |
| 1669742870 | Kirstin Allene Carhart | Registered Nurse | 1813 W Harvard Ave, Suite 436, Roseburg, OR 97471-2752 | 2012-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871574947 | Edgar Maeyens | Dermatology | 375 Park Ave, Suite 5, Coos Bay, OR 97420-2242 | 2005-11-07 |
| 1447713573 | Dermatology Health Specialists, PC | Dermatology | 1693 Sw Chandler Ave Ste 250, Bend, OR 97702-3231 | 2019-04-06 |
| 1972913259 | Lindsey Fix | Dermatology | 1605 G St, Springfield, OR 97477 | 2014-05-07 |
| 1558515494 | Jay Y Park Md, PC | Dermatology | 360 S Garden Way Ste 230, Eugene, OR 97401-8173 | 2008-11-05 |
| 1780846501 | Bend Memorial Clinic PC | Dermatology | 2600 Ne Neff Rd, Bend, OR 97701-6337 | 2008-07-02 |
| 1700081742 | Richard I. Ecker | Dermatology | 706 Ne Evans St, Mcminnville, OR 97128-3926 | 2007-06-19 |
| 1396845814 | Parwathi Vasudeva Paniker | Dermatology | 3600 N Interstate Ave, Portland, OR 97227-1106 | 2006-09-24 |
| 1184643249 | William J Delgado | Dermatology | 2705 Ne Conners Ave, Bend, OR 97701-6904 | 2006-07-19 |
| 1205805405 | Stephen N Snow | Dermatology | 3600 N Interstate Ave, Dermatology/mohs Surg Central Interstate Medical Office, Portland, OR 97227-1106 | 2006-03-17 |
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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.