PRAXIS MEDICAL GROUP, INC. (NPI# 1386145993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386145993 |
| Entity Type | Organization |
| Organization Name | PRAXIS MEDICAL GROUP, INC. |
| Other Organization Name | PENDLETON FAMILY MEDICINE |
| Practice Address |
2450 Sw Perkins Ave Pendleton OR 97801-4302 |
| Practice Telephone | 5412761700 |
| Practice Fax Number | 5412766327 |
| Mailing Telephone | 5412761700 |
| Mailing Fax Number | 5412766327 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |
| Authorized Official Name | GARRETT TK KENNEDY (BOARD SECRETARY) |
| Authorized Official Telephone | 5412784747 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRAXIS MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pendleton Family Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114261930 | Praxis Medical Group, Inc. | Clinic/Center | 18 Nw Oregon Ave, Bend, OR 97701-2729 | 2012-11-16 |
| 1821068164 | Praxis Medical Group, Inc. | Internal Medicine | 929 Sw Simpson Ave, Suite 300, Bend, OR 97702-3599 | 2006-01-26 |
| Street Address |
2450 SW PERKINS AVE |
| City | PENDLETON |
| State | OR |
| Zip Code | 97801-4302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104846351 | Robert G Johnson Jr. | Family Medicine | 2450 Sw Perkins Ave, Pendleton, OR 97801 | 2006-07-20 |
| 1508416785 | Mark Christopher Martindale | Physician Assistant | 2450 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2019-09-18 |
| 1992352892 | Meredith Cooper Dahle | Physician Assistant | 2450 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2019-08-25 |
| 1013409135 | Miriam Moriah Drummond | Physician Assistant | 2450 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2018-06-04 |
| 1417390949 | Jacqueline Elizabeth Brown | Physician Assistant | 2450 Sw Perkins Ave, Pendleton, OR 97801 | 2013-04-15 |
| 1104170489 | Chloe Kay Norris | Physician Assistant | 2450 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2012-11-07 |
| 1669745469 | Danielle Kathryn Addleman | Physician Assistant | 2450 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2012-02-10 |
| 1245568864 | Heidi A Tate | Physician Assistant | 2450 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2009-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720637119 | Yvonne Walker | Technician | 821 Se 9th St, Pendleton, OR 97801 | 2019-09-09 |
| 1083262703 | Praxis Medical Group Inc | Family Medicine | 2450 Sw Perkins Avenue, Pendleton, OR 97801 | 2019-08-27 |
| 1255826012 | Cosmas Chukwuemeka Nwerem Jr. | Pharmacist | 1900 Sw Court Place, Pendleton, OR 97801 | 2018-06-25 |
| 1689166811 | Helene Danielle Kuhn | Counselor | 4700 Nw Pioneer Pl, Pendleton, OR 97801 | 2018-06-04 |
| 1801302849 | Shawna L. All | Massage Therapist | 24 Se Emigrant Ave., Pendleton, OR 97801 | 2017-12-27 |
| 1033649256 | Sean Collins | Pharmacist | 203 Sw 20th St, Pendleton, OR 97801 | 2017-06-20 |
| 1073974796 | Channon M Baker | Peer Specialist | 7525 Westgate Bldg #2, Pendleton Creek Crisis Stabilization Unit, Pendleton, OR 97801 | 2016-03-08 |
| 1689034357 | Carre Biegel | Counselor | 17 Sw Frazer St, Ste 282, Pendleton, OR 97801 | 2016-02-24 |
| 1073995429 | Jessica Suzanne Pedersen | Massage Therapist | 812 Nw 12th St, Pendleton, OR 97801 | 2015-06-22 |
| 1861736373 | Christina Northern Northerhn | Social Worker | 331 Se 2nd Street, Pendleton, OR 97801 | 2012-11-21 |
| Find all providers in zip 97801 | ||||
| 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 |
|---|---|---|---|---|
| 1083262703 | Praxis Medical Group Inc | Family Medicine | 2450 Sw Perkins Avenue, Pendleton, OR 97801 | 2019-08-27 |
| 1629239355 | Stephanie Jane Russ | Family Medicine | 1251 S Huntzinger Blvd, Suite 100, Pendleton, IN 46064 | 2008-06-25 |
| 1649449166 | Manpreet Multani | Family Medicine | 3041 W Us Highway 36, Pendleton, IN 46064-9280 | 2008-02-28 |
| 1861675456 | Anmed Health | Family Medicine | 1005 Meehan Way, Pendleton, SC 29670-1824 | 2007-12-06 |
| 1841207255 | Eric C Jones | Family Medicine | 138 W State St, Pendleton, IN 46064-1034 | 2006-08-01 |
| 1346261971 | Community Hospitals of Indiana Inc | Family Medicine | 1251 Huntzinger Blvd, Suite 100, Pendleton, IN 46064-9493 | 2006-07-21 |
| 1790705259 | Pendleton Family Practice, LLC | Family Medicine | 101 Shirley St, Pendleton, SC 29670-1824 | 2006-07-20 |
| 1104846351 | Robert G Johnson Jr. | Family Medicine | 2450 Sw Perkins Ave, Pendleton, OR 97801 | 2006-07-20 |
| 1548299233 | Gary A Wright | Family Medicine | 75 Village Dr, Pendleton, IN 46064-8960 | 2006-07-03 |
| 1619911757 | Traci A Anderson | Family Medicine | 1251 Huntzinger Blvd Ste 100, Pendleton, IN 46064-9404 | 2006-06-16 |
| Find all providers in PENDLETON | ||||
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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.