ALLERGY & ASTHMA CENTER OF SOUTHERN OREGON PC (NPI# 1760548408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760548408 |
| Entity Type | Organization |
| Organization Name | ALLERGY & ASTHMA CENTER OF SOUTHERN OREGON PC |
| Practice Address |
3860 Crater Lake Ave Ste A Medford OR 97504-9741 |
| Practice Telephone | 5418581003 |
| Practice Fax Number | 5418574499 |
| Mailing Telephone | 5418581003 |
| Mailing Fax Number | 5418574499 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-07-13 |
| Authorized Official Name | EDWARD KERWIN (PHYSICIAN OWNER) |
| Authorized Official Telephone | 5418581003 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164562401 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 2628 Clover St, Klamath Falls, OR 97601-1132 | 2007-02-07 |
| 1205976867 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 2262 Ashland St, Ashland, OR 97520-1406 | 2007-02-06 |
| 1952441594 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 1722 Williams Hwy, Grants Pass, OR 97527-5661 | 2007-02-06 |
| 1851954853 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 1813 W Harvard Ave, Suite 241, Roseburg, OR 97471 | 2019-04-16 |
| Street Address |
3860 CRATER LAKE AVE STE A |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-9741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467995530 | Tiffany Smith | Physician Assistant | 3860 Crater Lake Ave Ste A, Medford, OR 97504-9741 | 2016-11-22 |
| 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 | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124172598 | Eric W. Bantz | Allergy & Immunology | 103 Old Marlton Pike Ste 211, Medford, NJ 08055-8772 | 2007-01-23 |
| 1912904624 | Joel G Bleier | Allergy & Immunology | 1 City Hall Mall, Medford, MA 02155-4770 | 2005-07-07 |
| 1568465847 | Edward Kerwin | Allergy & Immunology | 3860 Crater Lake Ave, Medford, OR 97504-9741 | 2005-05-31 |
| 1467499475 | Kevin Wilson Parks | Allergy & Immunology | 3860 Crater Lake Ave, Suite A, Medford, OR 97504-9741 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922304302 | Eastside Allergy Asthma & General Internal Medicine PC | Allergy & Immunology | 2850 Se Powell Blvd, Suite 206, Gresham, OR 97080-1494 | 2011-02-02 |
| 1164562401 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 2628 Clover St, Klamath Falls, OR 97601-1132 | 2007-02-07 |
| 1205976867 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 2262 Ashland St, Ashland, OR 97520-1406 | 2007-02-06 |
| 1952441594 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 1722 Williams Hwy, Grants Pass, OR 97527-5661 | 2007-02-06 |
| 1194733519 | Joel Michael Depper | Allergy & Immunology | 1250 Ne 3rd St, Suite B-100, Bend, OR 97701-4331 | 2006-08-03 |
| 1568482610 | Robert Henry Schwartz | Allergy & Immunology | 27 Ne Killingsworth St, Portland, OR 97211-2623 | 2006-07-20 |
| 1659317683 | John D Minor | Allergy & Immunology | 2233-f Willamette St, Allergy & Asthma Center PC, Eugene, OR 97405 | 2006-06-20 |
| 1134100092 | Kevin M Kral | Allergy & Immunology | 2065 Ne Williamson Ct, Suite A, Bend, OR 97701-3867 | 2005-11-08 |
| 1851954853 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 1813 W Harvard Ave, Suite 241, Roseburg, OR 97471 | 2019-04-16 |
| 1891905261 | Anita Tam Su | Allergy & Immunology | 545 Ne 47th Ave, Ste. 310, Portland, OR 97213-2238 | 2007-05-23 |
| Find all providers with the same taxonomy | ||||
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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.