PREMIER ENDOCRINOLOGY ASSOCIATES, LLC (NPI# 1376925719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376925719 |
| Entity Type | Organization |
| Organization Name | PREMIER ENDOCRINOLOGY ASSOCIATES, LLC |
| Other Organization Name | PREMIER ENDOCRINOLOGY ASSOCIATES |
| Practice Address |
960 Liberty Street Se Suite 170 Salem OR 97302 |
| Mailing Address |
700 Bellevue St Se Suite #290 Salem OR 97301-3819 |
| Practice Telephone | 5039674240 |
| Practice Fax Number | 5033399546 |
| Mailing Telephone | (503) 967-4240 |
| Mailing Fax Number | 5033399546 |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2017-08-21 |
| Authorized Official Name | LETICIA M. LOARCA (OFFICE MANAGER) |
| Authorized Official Telephone | 5039674240 |
| Is Organization Subpart | Y |
| Parent Organization Name | PREMIER ENDOCRINOLOGY ASSOCIATES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | LD-D-000451 | OR | Dietary & Nutritional Service Providers |
| N | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
LD-D-000451 | OR | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 26956 | 05 |
| Other Name | Type Code |
|---|---|
| Premier Endocrinology Associates | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PREMIER ENDOCRINOLOGY ASSOCIATES, LLC | 700 Bellevue St Se Ste 290, Salem, OR 97301 |
| Street Address |
960 LIBERTY STREET SE SUITE 170 |
| City | SALEM |
| State | OR |
| Zip Code | 97302 |
| 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 | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1730716069 | Bethany Frieler | Dietitian, Registered | 266 Missouri Ave S, Salem, OR 97302-4564 | 2020-03-25 |
| 1952865941 | Erica Lee Klag | Dietitian, Registered | 1 Oakland St, Salem, MA 01970-1520 | 2019-01-24 |
| 1306399761 | Michelle Garcia | Dietitian, Registered | 3886 Beverly Ave Ne Ste 6, Salem, OR 97305-1373 | 2016-08-02 |
| 1518321389 | Grace Wilburn | Dietitian, Registered | 306 Front Ave, Salem, VA 24153-6233 | 2016-04-07 |
| 1558772319 | Shannon Woodward D'aquila Haynes | Dietitian, Registered | 354 Darling Rd, Salem, CT 06420-3913 | 2014-05-14 |
| 1508284472 | Katherine Spann | Dietitian, Registered | 890 Oak St Se Bldg D, Salem, OR 97301-3905 | 2014-03-28 |
| 1194140970 | Barbara E. Rougier | Dietitian, Registered | 3r Oak View Ave, Salem, MA 01970-4315 | 2014-03-03 |
| 1881019784 | Jennifer E Jasmin | Dietitian, Registered | 46 Northey St, Salem, MA 01970-3905 | 2014-02-28 |
| 1851640486 | Ismini Soteropoulos | Dietitian, Registered | 39 Belleview Ave, Salem, MA 01970-1165 | 2012-08-29 |
| 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.