VIDA FAMILY MEDICINE (NPI# 1184086209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184086209 |
| Entity Type | Organization |
| Organization Name | VIDA FAMILY MEDICINE |
| Other Organization Name | VIDA INTEGRATIVE MEDICINE & MENTAL HEALTH |
| Practice Address |
374 Owens St Se Salem OR 97302-4183 |
| Mailing Address |
Po Box 883 Salem OR 97308-0883 |
| Practice Telephone | 5033991400 |
| Practice Fax Number | 5033991406 |
| Mailing Telephone | 5033991400 |
| Mailing Fax Number | 5033991406 |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2016-03-28 |
| Authorized Official Name | TERI LITKE (ADMINISTRATOR) |
| Authorized Official Telephone | 5033991400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
07-12-12 | OR | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | L6901 | OR | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | T0986 | OR | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | T0889 | OR | Behavioral Health & Social Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201402104-NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Vida Integrative Medicine & Mental Health | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | VIDA FAMILY MEDICINE, LLC | 374 Owens St Se Ste 100, Salem, OR 97302 |
| Street Address |
374 OWENS ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-4183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861479396 | Evelin Dacker | Family Medicine | 374 Owens St Se, Salem, OR 97302-4145 | 2005-12-27 |
| 1801291067 | Maansi Family Health Center | Naturopath | 374 Owens St Se, Salem, OR 97302-4183 | 2014-10-30 |
| 1457790826 | Groundswell Integrative Healthcare Inc. | Family Medicine | 374 Owens St Se, #100, Salem, OR 97302-4183 | 2013-06-19 |
| 1043546534 | Jeremy Gaylon Waldie | Physician Assistant | 374 Owens St Se, Salem, OR 97302-4183 | 2009-10-19 |
| 1235305020 | Andrew N Davis | Counselor | 374 Owens St Se, Salem, OR 97302-4183 | 2008-05-01 |
| 1598965238 | Ann M Gould | Physician Assistant | 374 Owens St Se, Ste 100, Salem, OR 97302-4183 | 2007-07-20 |
| 1356554752 | Nancy Ludwig | Dietitian, Registered | 374 Owens St Se, Suite 100, Salem, OR 97302 | 2007-05-08 |
| 1598834301 | Karen Bolinger Jones Shorr | Naturopath | 374 Owens St Se, Ste 100, Salem, OR 97302 | 2006-11-07 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366073421 | Aspire Telepsychiatry | Nurse Practitioner | 1910 24th St Ne, Salem, OR 97301-8150 | 2020-01-28 |
| 1962058362 | Kimberly Diane Nelson | Nurse Practitioner | 35 Congress St Ste 225, Salem, MA 01970-5529 | 2019-08-13 |
| 1861970972 | Norrine Mcnelley | Nurse Practitioner | 25 Beechwood Rd, Salem, NH 03079 | 2018-07-31 |
| 1235493495 | Sarah Frances Robbins | Nurse Practitioner | 1595 Roosevelt St Ne, Salem, OR 97301 | 2012-07-02 |
| 1700155538 | Vanessa Anne Underwood | Nurse Practitioner | 1595 Cottage St Ne, Salem, OR 97301-7123 | 2011-12-22 |
| 1134364524 | Sharon Vaden Karn | Nurse Practitioner | 870 Commercial St Se, Salem, OR 97302-4108 | 2008-12-12 |
| 1861605768 | Barbara S Miller | Nurse Practitioner | Odoc, 2605 State St, Salem, OR 97310-0001 | 2007-05-07 |
| 1538225818 | Aleyna Cecile Reed | Nurse Practitioner | 685 Cottage St Ne, Salem, OR 97301-2419 | 2006-12-29 |
| 1407915408 | James Ben Newman | Nurse Practitioner | 1235 Woodrow St Ne, Salem, OR 97303-3214 | 2006-12-06 |
| 1033285713 | Rita Herlong | Nurse Practitioner | 4035 12th Street Cutoff, Suit120, Salem, OR 97302-1764 | 2006-11-27 |
| Find all providers in SALEM | ||||
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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.