PROFESSIONAL MEDICAL SERVICES LLC (NPI# 1366628794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366628794 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL MEDICAL SERVICES LLC |
| Other Organization Name | PROFESSIONAL MEDICAL SERVICES AT MEDFORD |
| Practice Address |
2825 E Barnett Rd Medford OR 97504-8332 |
| Mailing Address |
2241 Lloyd Center Portland OR 97232-1315 |
| Practice Telephone | 5417895220 |
| Mailing Telephone | 5034948417 |
| Mailing Fax Number | 5034944455 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |
| Authorized Official Name | DAVID CRAWFORD (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5034949616 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROFESSIONAL MEDICAL SERVICES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 227631 | 05 | |
| WA | 7119944 | 05 |
| Other Name | Type Code |
|---|---|
| Professional Medical Services at Medford | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952587370 | Professional Medical Services LLC | Internal Medicine | 1501 Ne Medical Center Dr, Bend, OR 97701-6051 | 2008-01-16 |
| 1770687253 | Professional Medical Services LLC | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-09-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PROFESSIONAL MEDICAL SERVICES LLC | 2055 Nw Savier St Ste 201, Portland, OR 97209 |
| Street Address |
2825 E BARNETT RD |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770587107 | Asante | General Acute Care Hospital | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2005-06-13 |
| 1497352975 | Angela Kim | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2020-10-07 |
| 1093330235 | James Allen Garcia | Registered Nurse | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2020-06-13 |
| 1386283166 | Ruthie Nguyen | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-12-27 |
| 1235772401 | Michael Lanning | Pharmacy | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-10-21 |
| 1487295994 | Nicole Mehl | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-10-06 |
| 1073154191 | Therese Marguerite Wavrin | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-30 |
| 1063063311 | Kirsten Laity | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-26 |
| 1790336568 | Shane Vanhandel | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-24 |
| 1861043663 | Rebecca Ann Kimmel | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962469585 | Alison Diana Savage | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2006-04-27 |
| 1487618328 | Aleksandra Simic Sander | Internal Medicine | 2828 E Barnett Road, Medford, OR 97504 | 2006-04-17 |
| 1508421751 | Ethan Pace | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2019-05-02 |
| 1104866193 | Susan E Kohler | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2006-06-07 |
| 1245286301 | Charles R Dibb | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2006-05-26 |
| 1124073671 | Gerald B Ahmann | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2006-05-23 |
| 1952355000 | Richard K Karchmer | Internal Medicine | 19 Myrtle St, Medford, OR 97504-7337 | 2006-05-22 |
| 1528011350 | Sandra J Taylor | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2006-05-19 |
| 1043263619 | Hematology Oncology Associates, P.C. | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2006-05-18 |
| 1386696490 | Sean T Hehn | Internal Medicine | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2006-05-17 |
| Find all providers in MEDFORD | ||||
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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.