NPIMap

Organization Active NPI

Vida Family Medicine, LLC

Doing business as Vida Integrative Medicine & Mental Health

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1063567832
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VIDA FAMILY MEDICINE, LLC
Doing business as
Vida Integrative Medicine & Mental Health
Practice address
374 Owens St SE Ste 100
Salem, OR 97302-4183
Phone
(503) 399-1400
Fax
(503) 399-1406
NPI assigned
Jan 24, 2007
Last updated
Apr 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Teri L Litke-Fetsch
Title
Administrator
Phone
(503) 399-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

374 Owens St SE Ste 100
Salem, OR 97302-4183

Mailing address

PO Box 883
Salem, OR 97308-0883
Phone (503) 399-1400

Other names 1

  • Vida Integrative Medicine & Mental Health Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1063567832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 883",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973080883",
            "telephone_number": "503-399-1400",
            "fax_number": "503-399-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 OWENS ST SE STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024183",
            "telephone_number": "503-399-1400",
            "fax_number": "503-399-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "LITKE-FETSCH",
        "authorized_official_first_name": "TERI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-399-1400"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vida Integrative Medicine & Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.