G JASON WILKS (NPI# 1316006539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316006539 |
| Entity Type | Individual |
| Full Name | G JASON WILKS |
| Other Name | GORDON JASON WILKS |
| Credential | DPM |
| Practice Address |
2564 Nw Edenbower Blvd Suite 142 Roseburg OR 97471-8854 |
| Mailing Address |
2579 Nw Edenbower Blvd Roseburg OR 97471-6220 |
| Practice Telephone | 5416730742 |
| Practice Fax Number | 5416737553 |
| Mailing Telephone | 5416730742 |
| Mailing Fax Number | 5416737553 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2018-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | DP00318 | OR | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | REGENCE BC HMO | 430895102 | 01 |
| OR | PACIFIC SOURCE | D201111 | 01 |
| OR | REGENCE | 067946000 | 01 |
| RR MEDICARE | 480028890 | 01 | |
| OR | 500720262 | 05 |
| Street Address |
2564 NW EDENBOWER BLVD SUITE 142 |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-8854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841246048 | Lisa A Brandenburger | Internal Medicine | 2564 Nw Edenbower Blvd, Suite 126, Roseburg, OR 97471-8821 | 2006-05-26 |
| 1639614647 | G Jason Wilks Dpm PC | Podiatrist | 2564 Nw Edenbower Blvd, Ste 142, Roseburg, OR 97471-8854 | 2016-12-29 |
| 1912234048 | Linda Sewell Md., PC | Obstetrics & Gynecology | 2564 Nw Edenbower Blvd, Suite 134, Roseburg, OR 97471-8854 | 2009-11-10 |
| 1265584734 | Laboratory Corporation of America | Clinical Medical Laboratory | 2564 Nw Edenbower Blvd, Suite 114, Roseburg, OR 97470-8854 | 2007-01-17 |
| 1609880368 | Linda L Sewell | Obstetrics & Gynecology | 2564 Nw Edenbower Blvd, Ste 134, Roseburg, OR 97471 | 2006-07-28 |
| 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 | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689677031 | Kash K. Siepert | Podiatrist | 2300 Nw Stewart Pkwy, Roseburg, OR 97471-1597 | 2005-05-31 |
| 1639614647 | G Jason Wilks Dpm PC | Podiatrist | 2564 Nw Edenbower Blvd, Ste 142, Roseburg, OR 97471-8854 | 2016-12-29 |
| 1720491046 | Nathaniel Keplinger | Podiatrist | 2300 Nw Stewart Pkwy, Roseburg, OR 97471-1597 | 2014-06-04 |
| 1851622153 | Roseburg Foot & Ankle Specialists, P.C. | Podiatrist | 2300 Nw Stewart Pkwy, Roseburg, OR 97471 | 2010-01-26 |
| 1730275355 | Fadi Elias Malak | Podiatrist | 913 Nw Garden Valley Blvd, Roseburg, OR 97470-6523 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154869659 | Mid-columbia Medical Center | Podiatrist | 33 Nichols Pkwy, Hood River, OR 97031-3121 | 2017-02-03 |
| 1033560867 | John M Barnes Dpm LLC | Podiatrist | 9615 Nw Randall Ln, Portland, OR 97229-5294 | 2016-06-22 |
| 1619338829 | Cara Beach | Podiatrist | 9900 Sw Hall Blvd Ste 100, Portland, OR 97223-5838 | 2016-03-15 |
| 1265743090 | Nanjin Jasmine Park | Podiatrist | 5311 Sw Baird St, Portland, OR 97219-5023 | 2010-06-26 |
| 1689991804 | Cassandra Bree Tomczak | Podiatrist | 19250 Sw 65th Ave Ste 200, Tualatin, OR 97062 | 2010-04-27 |
| 1326363839 | Kessa Mauras | Podiatrist | 1100 E. Marina Way, Suite 223, Hood River, OR 97031 | 2010-03-29 |
| 1598907537 | Joshua Johnson Boone | Podiatrist | 551 Lone Prine Blvd, The Dalles, OR 97058 | 2009-04-06 |
| 1699928168 | Kristy R Six | Podiatrist | 400 Sw Bluff Dr Ste 220, Bend, OR 97702-1697 | 2008-10-28 |
| 1306093265 | Gilbert Alan Hice | Podiatrist | 953 Foots Creek Road, Gold Hill, OR 97525 | 2008-08-22 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| 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.