MR. BENJAMIN HEARTY (NPI# 1366890386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366890386 |
| Entity Type | Individual |
| Full Name | MR. BENJAMIN HEARTY |
| Credential | PA-C |
| Practice Address |
24461 E Welches Rd Welches OR 97067 |
| Mailing Address |
Po Box 378 Welches OR 97067-0378 |
| Practice Telephone | 5036223126 |
| Mailing Telephone | 5036223126 |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2018-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA185335 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2730 Sw Moody Ave # Cl5pa, Portland, OR 972015042 | 5034943633 |
| Street Address |
24461 E WELCHES RD |
| City | WELCHES |
| State | OR |
| Zip Code | 97067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811951148 | Murlan E Grise | Family Medicine | 24461 E Welches Rd, Welches, OR 97067-7067 | 2006-04-13 |
| 1861944894 | Northwest Medical Foundation of Tillamook | General Acute Care Hospital | 24461 E Welches Rd, Welches, OR 97067-7067 | 2016-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285634097 | Brad Alexander Mckenzie | Dentist | 24540 E. Welches Rd., Welches, OR 97067 | 2005-07-22 |
| 1518280072 | Brad A. Mckenzie | Dentist | 24540 E Welches Rd, Welches, OR 97067 | 2010-03-11 |
| 1134354855 | Frank George Cooper | Counselor | 24525 E Welches Rd, Welches, OR 97067-0347 | 2009-05-26 |
| 1811101876 | Robert H Kelly | Dentist | 24540 E Welches Rd, Welches, OR 97067-0347 | 2007-05-09 |
| 1245669456 | Robert H Kelly, Dmd PC | Dentist | 24540 E Welches Rd, Welches, OR 97067-0347 | 2013-11-07 |
| 1497095137 | Molly Stein | Mechanotherapist | 24540 E Welches Rd, Welches, OR 97067-0347 | 2013-02-16 |
| 1215557319 | Genevieve White | Health Educator | 67477 E Bright Ct, Welches, OR 97067-8708 | 2020-04-20 |
| 1669006540 | Janet S. Whitacre | Massage Therapist | 67211 E Highway 26, Welches, OR 97067-8797 | 2020-02-28 |
| 1326484338 | Williams Pharmacy LLC | Pharmacy | 67195 E Highway 26, Welches, OR 97067-9761 | 2013-05-16 |
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495569 | Lynsie Wolfe | Physician Assistant | 3000 Bryant Williams Dr Ste 200, Klamath Falls, OR 97601-1140 | 2020-10-22 |
| 1548867856 | Megan Elaine Stewart | Physician Assistant | 3773 Pinetop Dr, Medford, OR 97504-9638 | 2020-10-08 |
| 1639786411 | Bridget Meade-sentosun | Physician Assistant | 2599 Ne Overlook Dr Apt 815, Hillsboro, OR 97124-7613 | 2020-09-25 |
| 1518570738 | Samantha Larelle Williamson | Physician Assistant | 1551 2nd St, Umatilla, OR 97882-9707 | 2020-08-27 |
| 1356951891 | Eric James Humphrey | Physician Assistant | 1055 Ne Creeksedge Dr, Hillsboro, OR 97124-1316 | 2020-08-07 |
| 1427676493 | Lindsey Louise Peterson | Physician Assistant | 3505 N Williams Ave, Portland, OR 97227-1437 | 2020-07-07 |
| 1871110361 | Dana Sierra Jackson | Physician Assistant | 370 Ne Garner St, Prineville, OR 97754-2039 | 2020-06-30 |
| 1518584036 | Abigail Nichole Dumont | Physician Assistant | 6064 Sw 30th Ave, Portland, OR 97239-1018 | 2020-06-30 |
| 1831712280 | Joshua Sprague | Physician Assistant | 6501 Ne Cherry Dr Apt 1112, Hillsboro, OR 97124-7711 | 2020-05-20 |
| 1376165134 | Emily Axelrod | Physician Assistant | 19648 Wildwood Dr, West Linn, OR 97068-2210 | 2020-05-14 |
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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.