RANDELL PETER JURA (NPI# 1104272921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104272921 |
| Entity Type | Individual |
| Full Name | RANDELL PETER JURA |
| Credential | M.D. |
| Practice Address |
4666 Commercial St Se Salem OR 97302-1902 |
| Practice Telephone | 5033997607 |
| Practice Fax Number | 5033641016 |
| Mailing Telephone | 5033997607 |
| Mailing Fax Number | 5033641016 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
12431 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 26053-9 | 05 | |
| OR | OREGON WORKERS COMP | 0000BHPBD | 01 |
| Street Address |
4666 COMMERCIAL ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417915356 | Geary Joe Michels | Chiropractor | 4666 Commercial St Se, Salem, OR 97302-1902 | 2006-05-02 |
| 1245720226 | Julia Robertson D.c. LLC | Chiropractor | 4666 Commercial St Se, Salem, OR 97302 | 2018-05-15 |
| 1053809947 | Julia R Robertson | Chiropractor | 4666 Commercial St Se, Salem, OR 97302 | 2018-04-25 |
| 1003089335 | Geary J Michels, D.c., P.c | Chiropractor | 4666 Commercial St Se, Salem, OR 97302-1902 | 2008-04-08 |
| 1851484372 | Rpjura Medical, PC | Family Medicine | 4666 Commercial St Se, Salem, OR 97302-1902 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538495734 | Ole Hansen | Family Medicine | 2605 State St, Salem, OR 97310-1346 | 2009-10-22 |
| 1568485043 | Anton John Dubrick | Family Medicine | 420 W Schwartz St, Salem, IL 62881-1552 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700421435 | Carehere LLC | Family Medicine | 12106 Ne Ainsworth Cir Ste 5, Portland, OR 97220-9001 | 2019-11-18 |
| 1053839217 | Transitional Life Care Clinic, Inc. | Family Medicine | 15604 Sw Rock of Ages Rd, Mcminnville, OR 97128-8531 | 2017-09-07 |
| 1588088785 | Robert Michael Hakala | Family Medicine | 2300 Neff Road, Volunteers In Medicine Clinic, Bend, OR 97701 | 2014-02-07 |
| 1043453582 | Paul E Vanbredavriesman | Family Medicine | 18000 Se Stark Street, Gresham, OR 97233 | 2009-04-14 |
| 1154548881 | Leta Teresa Callahan | Family Medicine | 230 Rowe Road, Wheeler, OR 97147 | 2007-04-20 |
| 1952527871 | Ben Harold Douglas II | Family Medicine | 1100 3rd St, Tillamook, OR 97141-3402 | 2007-04-18 |
| 1629109335 | Melissa Noble | Family Medicine | 628 N Main Street, Ashland, OR 97520-1710 | 2007-03-07 |
| 1730275488 | Richard Hansen | Family Medicine | 300 N Mill St Ste A, Creswell, OR 97426-9848 | 2006-10-04 |
| 1376584011 | Leonard Dewitt Savage | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2006-06-10 |
| 1346202082 | David Snook | Family Medicine | 367 Normal Ave, Ashland, OR 97520-1329 | 2006-04-06 |
| Find all providers with the same taxonomy | ||||
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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.