SALEM EMERGENCY PHYSICIANS SERVICE, PC


Address: 890 Oak Street, Se Building 'a', Salem, OR 97301-3905
Phone: 5035615634

SALEM EMERGENCY PHYSICIANS SERVICE, PC (NPI# 1063454395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063454395
Entity Type Organization
Organization Name SALEM EMERGENCY PHYSICIANS SERVICE, PC
Practice Address 890 Oak Street
Se Building 'a'
Salem
OR 97301-3905
Mailing Address Po Box 742547
Los Angeles
CA 90074-2547
Practice Telephone 5035615634
Practice Fax Number 5038141071
Mailing Telephone 5035615634
Mailing Fax Number 5038141071
Enumeration Date 2006-06-12
Last Update Date 2019-11-05
Authorized Official Name MR. ROBERT KELLY (MD)
Authorized Official Telephone 5035615634
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207P00000X Emergency Medicine Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WASHINGTON CRIME VICTIMS 8902424 01
RAILROAD MEDICARE CR0251 01
WA 7028699 05
BLUE CROSS & BLUE SHIELD 015388000 01
WASHINGTON L&I 042080 01
OR 115808 05
OR 168143 05
GROUP HEALTH 68701001 01

Office Location

Street Address 890 OAK STREET
SE BUILDING 'A'
City SALEM
State OR
Zip Code 97301-3905

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NPI Name Taxonomy Address Enumeration
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1760018360 Riverfront Mental Health LLC Counselor 338 State St, Suite 985, Salem, OR 97301 2020-03-16
1871126888 Amity Beth Haddon Maxwell Social Worker Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 2020-02-18
1861042632 Brenda Grizelda Vargas Behavioral Analyst 3400 State Ste Ste G750, Salem, OR 97301 2019-09-13
1588213177 Natalie Stone Registered Nurse 2045 Siverton Rd Ne, Salem, OR 97301 2019-09-06
1588228720 Jeramy Disenso Counselor 270 Cottage St Ne, Salem, OR 97301 2019-04-23
1801353297 Gwendolyn Kersey Registered Nurse 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 2019-02-21
1841769114 Spine Clinic PC Massage Therapist 1281 Lancaster Drive Ne, Salem, OR 97301 2018-11-16
1013482132 Kellie Linn Hansen Physical Therapist 4049 Market St Se, Salem, OR 97301 2018-10-04
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Taxonomy Information

Taxonomy Code 207P00000X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine

Taxonomy Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source]
- Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1760725485 Deirdre Harmony Witte Emergency Medicine Salem Emergency Physicians, C/o Salem Hospital Ed, 890 Oak St, Se, Building A, Salem, OR 97301 2013-04-01
1689992117 Jillian Colleen Schmunk Emergency Medicine 890 Oak Street, Se, Building A, Salem Emergency Physicians Services, Salem, OR 97301 2010-05-07
1184894081 Lourdes Maria Page Emergency Medicine 429 Homeplace Dr, Salem, VA 24153-7158 2008-03-06
1750589024 Vicky L Gulley Emergency Medicine 35629 Hwy 72, Pob 1, Suite 3, Salem, MO 65560 2007-07-06
1477672483 Michael Joseph Barra Emergency Medicine 890 Oak St Se Bldg A, Salem, OR 97301-3905 2007-03-29
1396810206 David Austin Rideout Emergency Medicine 60 Washington St Ste 403, Salem, MA 01970-3517 2006-11-24
1134204795 Fulton County Hospital Emergency Medicine 679 North Main, Salem, AR 72576 2006-10-25
1154336444 Jenai E Beland Cohen Emergency Medicine Salem Hospital, 81 Highland Avenue, Salem, MA 01970 2006-07-29
1013942192 John A Michael Emergency Medicine 28 1/2 Broad St, Salem, MA 01970-3143 2006-07-11
1447293337 Davis K Cho Emergency Medicine 1002 Bellevue St Se, Salem, OR 97301-4006 2006-06-14
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Competitor

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City SALEM
Zip Code 97301

Improve Information

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Dataset Information

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.

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