REBECCA L PENGILLY (NPI# 1184603680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184603680 |
| Entity Type | Individual |
| Full Name | REBECCA L PENGILLY |
| Credential | MD |
| Practice Address |
1705 Waverly Dr Se Albany OR 97322-6952 |
| Mailing Address |
444 Nw Elks Dr Corvallis OR 97330-3745 |
| Practice Telephone | 5419678221 |
| Mailing Telephone | (541) 967-8221 |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD182380 | OR | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 5123 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 5611360 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 901 4th St Nw, Watertown, SD 572011558 | 6058868471 | 6058869317 |
| Street Address |
1705 WAVERLY DR SE |
| City | ALBANY |
| State | OR |
| Zip Code | 97322-6952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275941486 | Jorden D.. Hinds | Physical Therapist | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2014-07-31 |
| 1194901405 | Yvonne Elaine Keep | Nurse Practitioner | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2008-01-16 |
| 1235351974 | Raymond N Chin | Family Medicine | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2007-05-03 |
| 1518008994 | Albany Family and Specialty Medicine | Non-Pharmacy Dispensing Site | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2007-02-09 |
| 1518048438 | Richard Lloyd Julyan | Family Medicine | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2006-10-18 |
| 1598715021 | Christopher P Swan | Family Medicine | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2006-05-12 |
| 1720038755 | Harry Daniels Moore | Family Medicine | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2006-05-11 |
| 1992755847 | Jeffrey E Robinson | Family Medicine | 1705 Waverly Dr Se, Albany, OR 97322-6952 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083109748 | Benjamin Voth | Counselor | 1858 Grand Prairie Rd Se, Albany, OR 97322 | 2018-06-26 |
| 1033534748 | Willamette Orthotics & Prosthetics, LLC | Durable Medical Equipment & Medical Supplies | 1630 9th Ave Se, Albany, OR 97322 | 2014-03-04 |
| 1699035998 | Morgan William Brown | Behavioral Analyst | 1885 21 St Ave Se Apt 44, Albany, OR 97322 | 2012-05-21 |
| 1780986059 | Gene Vang | Pharmacist | 1330 Goldfish Farm Rd Se, Albany, OR 97322 | 2010-11-18 |
| 1427362912 | Kate Fredrickson | Speech-Language Pathologist | 5353 Columbus St. Se, Albany, OR 97322 | 2010-07-27 |
| 1689906455 | Sandy Janiszewski | Registered Nurse | 1970 4th Ave. Se, Ste 120, Albany, OR 97322 | 2010-02-04 |
| 1841527066 | Karina Leonore Towers | Speech-Language Pathologist | 5353 Columbus Street Se, Albany, OR 97322 | 2009-11-09 |
| 1548497951 | T.c.s. Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3012 Se Oakwood Avenue, Albany, OR 97322 | 2009-06-12 |
| 1790932952 | Ramel C Romero | Physical Therapist | 5353 Colombus St Se, Albany, OR 97322 | 2008-08-19 |
| 1023275492 | Michael James | Hearing Instrument Specialist | 1610 9th Av. Se, Albany, OR 97322 | 2008-05-21 |
| Find all providers in zip 97322 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1407492796 | American Ecare | Family Medicine | 3 Computer Dr W Ste 107, Albany, NY 12205-1621 | 2019-11-21 |
| 1124678347 | Carehere LLC | Family Medicine | Carehere Clinic- City of Albany, Ga, 2000 North Monroe Street, Albany, GA 31701 | 2019-09-19 |
| 1790332831 | Granland3 LLC | Family Medicine | 2622 Dawson Rd, Albany, GA 31707-1609 | 2019-08-22 |
| 1295397065 | Cerrito Creek Family Medicine Inc | Family Medicine | 400 Evelyn Ave., St. 107, Albany, CA 94706 | 2019-07-02 |
| 1487190526 | Tracey Anyanwu | Family Medicine | 539 N Westover Blvd, 133, Albany, GA 31707-1951 | 2017-01-12 |
| 1275911828 | St Claire Gitau Sumaili | Family Medicine | 2403 Osler Ct Ste A, Albany, GA 31707-0205 | 2015-05-15 |
| 1235516071 | Daniel Barton Mosher | Family Medicine | 2605 Willetta St Sw Ste D1, Albany, OR 97321-3481 | 2015-04-30 |
| 1508129214 | Alan Shifman Charles | Family Medicine | 741 Gateview Ave, Albany, CA 94706-1029 | 2012-06-18 |
| 1770840324 | Joseph A Kelly | Family Medicine | 27 Park Ln E, #2, Albany, NY 12204-1960 | 2012-04-20 |
| Find all providers in ALBANY | ||||
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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.