WVP MEDICAL GROUP, LLC (NPI# 1538535059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538535059 |
| Entity Type | Organization |
| Organization Name | WVP MEDICAL GROUP, LLC |
| Other Organization Name | WVP INDEPENDENCE MONMOUTH |
| Practice Address |
1430 Monmouth St Independence OR 97351-1127 |
| Mailing Address |
2995 Ryan Dr Se Ste 200 Salem OR 97301-5157 |
| Practice Telephone | 5038381133 |
| Practice Fax Number | 5038385138 |
| Mailing Telephone | 5033717701 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | MR. DEAN ANDRETTA (CFO) |
| Authorized Official Telephone | 5033717701 |
| Is Organization Subpart | Y |
| Parent Organization Name | MID VALLEY IPA, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 288533 | 05 |
| Other Name | Type Code |
|---|---|
| WVP Independence Monmouth | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922583616 | Wvp Medical Group, LLC | Clinic/Center | 2995 Ryan Dr Se Ste 200, Salem, OR 97301-5157 | 2018-09-27 |
| 1831504968 | Wvp Medical Group, LLC | Clinic/Center | 2485 12th St. Se, Salem, OR 97302-0000 | 2014-06-27 |
| 1982148789 | Wvp Medical Group, LLC | Internal Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2016-12-13 |
| 1710231550 | Wvp Medical Group, LLC | Family Medicine | 2365 Grear St Ne, Salem, OR 97301-2747 | 2012-11-01 |
| 1518225242 | Wvp Medical Group, LLC | Clinic/Center | 1155 Mission St Se, Suite 205, Salem, OR 97302-6228 | 2012-05-01 |
| 1164780060 | Wvp Medical Group, LLC | Clinic/Center | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2012-04-27 |
| 1538459938 | Wvp Medical Group, LLC | Clinic/Center | 2478 13th St Se, Ste. 200, Salem, OR 97302-2546 | 2011-04-19 |
| 1750684767 | Wvp Medical Group, LLC | Clinic/Center | 5100 River Rd N, Keizer, OR 97303-5371 | 2010-12-13 |
| 1124352877 | Wvp Medical Group, LLC | Family Medicine | 2485 12th St Se, Salem, OR 97302-2151 | 2009-09-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WVP MEDICAL GROUP, LLC | 245 Commercial St Se Ste 200, Salem, OR 97301 |
| Street Address |
1430 MONMOUTH ST |
| City | INDEPENDENCE |
| State | OR |
| Zip Code | 97351-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598868515 | Independence-monmouth Family Medicine PC | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| 1083092514 | Shelly Wimmer | Physician Assistant | 1430 Monmouth St, Independence, OR 97351-1127 | 2015-05-17 |
| 1972990174 | Terrell Glenn | Family Medicine | 1430 Monmouth St, Independence, OR 97351-1127 | 2015-04-25 |
| 1265727515 | Mary Susanne Placek | Family Medicine | 1430 Monmouth St, Independence, OR 97351-1127 | 2011-06-15 |
| 1659490092 | Janice Hoida | Physician Assistant | 1430 Monmouth St, Independence, OR 97351-1127 | 2007-03-28 |
| 1407959422 | Keith Allen White | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821070111 | Kenneth R Winokur | Dentist | 329 South Main St, Independence, OR 97351 | 2005-11-14 |
| 1710044144 | Kenneth R Winokur Dmd PC | Dentist | 329 S Main St, Independence, OR 97351 | 2007-01-03 |
| 1609901024 | Evan L Evans | Audiologist | 1343 A Monmouth St, Independence, OR 97351-0248 | 2007-02-23 |
| 1497703201 | Evergreen Oregon Healthcare Independence, L.L.C. | Skilled Nursing Facility | 1525 Monmouth St, Independence, OR 97351-1007 | 2006-05-04 |
| 1518127844 | David Patrick Mcdarby | Physical Therapist | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| 1881854115 | Bobbi Jo Shrum | Physical Therapy Assistant | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| 1639426208 | Central School District 13j | Local Education Agency (LEA) | 1610 Monmouth St, Independence, OR 97351-1008 | 2012-08-13 |
| 1851645931 | Holli Watkin | Nurse Practitioner | 1601 Monmouth St Ste 100, Independence, OR 97351-1019 | 2012-10-29 |
| 1699394585 | Jennifer Elizabeth O'sullivan | Specialist/Technologist | 1369 Monmouth St, Independence, OR 97351-1126 | 2020-04-10 |
| 1336108711 | Independence Pharmacy, Inc | Pharmacy | 1357 Monmouth St, Independence, OR 97351-1126 | 2006-03-22 |
| Find all providers in zip 97351 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1811186372 | Morack Chiropractic Center, P.C. | Clinic/Center | 4014a S Lynn Ct Dr, Independence, MO 64055-3360 | 2007-10-22 |
| 1336193986 | Millennium Rehab & Consulting, Inc. | Clinic/Center | 2300 Swan Lake Blvd, Suite 103, Independence, IA 50644-9708 | 2006-05-19 |
| 1932522182 | Drbryanbaker.com LLC | Clinic/Center | 13723 E 39th St S, Independence, MO 64055-3321 | 2014-01-23 |
| 1821335134 | Charles E Mcgrath Do PC | Clinic/Center | 514 S Noland Rd, Suite 130, Independence, MO 64050-3976 | 2013-01-07 |
| 1154553006 | Johnson Chiropractic Inc | Clinic/Center | 311 E Main St, Independence, KS 67301-3713 | 2009-08-11 |
| 1518152966 | Ramic Independence, LLC | Clinic/Center | 3431 S Hwy 291, Independence, MO 64057-2341 | 2007-09-10 |
| 1942413521 | Tlc The Laser Center (northeast) Inc. | Clinic/Center | 6500 Rockside Rd, Ste 100, Independence, OH 44131-2368 | 2007-05-08 |
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|---|---|---|---|---|
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| 1427662204 | Edmund H. Torkelson Do, PC | Clinic/Center | 1960 Nw 167th Pl Ste 204, Beaverton, OR 97006-4804 | 2020-08-31 |
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| 1801413240 | Gfm LLC | Clinic/Center | 1235 Se Division St Ste 114, Portland, OR 97202-1042 | 2020-07-01 |
| 1184240277 | Evans & Company Healthcare PC | Clinic/Center | 2330 Morada Ln, Ashland, OR 97520-3641 | 2020-06-24 |
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| 1275168759 | Metatron Health LLC | Clinic/Center | 6464 Sw Borland Rd Ste C3, Tualatin, OR 97062-8856 | 2020-03-05 |
| 1427680057 | Ortc, LLC | Clinic/Center | 750 Biddle Rd Ste 102, Medford, OR 97504-6178 | 2020-02-11 |
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1861038382 | Clackamas County | Clinic/Center | 2051 Kaen Rd Ste 210, Oregon City, OR 97045-4035 | 2019-11-19 |
| Find all providers with the same taxonomy | ||||
| City | INDEPENDENCE |
| Zip Code | 97351 |
Please comment or provide details below to improve the information on WVP MEDICAL GROUP, LLC.
| 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.