Challis A Casebolt (NPI# 1558486209, PAC ID# 3476740861) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1558486209 |
| PAC ID by PECOS | 3476740861 |
| Professional Enrollment ID | I20101210000719 |
| Full Name | Challis A Casebolt |
| Organization Legal Name | WATERFALL CLINIC INCORPORATED |
| Address |
1890 Waite St North Bend OR 97459-1229 |
| Gender | F |
| Graduation Year | 1997 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5698740355 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380090 | BAY AREA HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1890 Waite St, North Bend, OR 97459-1229 | WATERFALL CLINIC INCORPORATED |
| Organization Legal Name | WATERFALL CLINIC INCORPORATED |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald M St Jean | Clinical Social Worker | Waterfall Clinic Incorporated | 1950 Waite St, North Bend, OR 97459-1228 |
| Shirley D Reynolds | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Shu-wen Cheng | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| Pernilla Johansson | Clinical Social Worker | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Denise J Gontiz | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| David W Walker | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Pei J Purdom | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Yvonne L Fenrich | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Toyin A Akanni | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Michael Huck | Clinical Social Worker | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Street Address |
1890 WAITE ST |
| City | NORTH BEND |
| State | OR |
| Zip | 97459-1229 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shirley D Reynolds | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Pernilla Johansson | Clinical Social Worker | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| David W Walker | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Pei J Purdom | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Yvonne L Fenrich | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Toyin A Akanni | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Michael Huck | Clinical Social Worker | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Abdul Hai Kazemy | Internal Medicine | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Amy E Hinshaw | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Amy Elizabeth Hinshaw | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard S Roberts | Oral Surgery | 3500 Cedar St, North Bend, OR 97459-1108 | |
| Melody L Sheldon | Qualified Speech Language Pathologist | 2085 Inland Dr A, North Bend, OR 97459-1203 | |
| William A Bennett | Podiatry | 2085 Inland Dr, Suite B, North Bend, OR 97459-1203 | |
| Ronald M St Jean | Clinical Social Worker | Waterfall Clinic Incorporated | 1950 Waite St, North Bend, OR 97459-1228 |
| Kathleen Emma Voge | Clinical Social Worker | Waterfall Clinic Incorporated | 1950 Waite St, North Bend, OR 97459-1228 |
| Jane Gilbert | Ophthalmology | Bay Eye Clinic PC | 3585 Broadway Ave, North Bend, OR 97459-1251 |
| Jon C Kintner | Ophthalmology | Bay Eye Clinic PC | 3585 Broadway Ave, North Bend, OR 97459-1251 |
| Debra A Graham | Ophthalmology | Bay Eye Clinic PC | 3585 Broadway Ave, North Bend, OR 97459-1251 |
| Bryon G Blackwell | Chiropractic | 2582 Broadway Ave, North Bend, OR 97459-1635 | |
| Sherry L Williams | Podiatry | 3229 Broadway St D, North Bend, OR 97459-2203 | |
| Find all physicians in zip 97459 | |||
| City | NORTH BEND |
| Zip Code | 97459 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | NORTH BEND + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Challis A Casebolt.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.