Jordan Valley Health Clinic, Inc.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MD09143 Issued in OR

Legal business name

JORDAN VALLEY HEALTH CLINIC, INC.

Practice address

400 Iowa Ave.
Jordan Valley, OR 97910

Phone

(541) 586-2422

Fax

(541) 586-2419

NPI assigned

Jul 17, 2006

Last updated

Feb 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marie Clayton

Title

Office Manager

Phone

(541) 586-2422

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Michael Lounsbury, PAC

  • Medical Physician Assistant
  • Moscow, ID
  • NPI 1356346712
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1093733248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 118",
            "city": "JORDAN VALLEY",
            "state": "OR",
            "postal_code": "979100118",
            "telephone_number": "541-586-2422",
            "fax_number": "541-586-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 IOWA AVE.",
            "city": "JORDAN VALLEY",
            "state": "OR",
            "postal_code": "97910",
            "telephone_number": "541-586-2422",
            "fax_number": "541-586-2419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN VALLEY HEALTH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-586-2422"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "MD09143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Marie Donley Burge, CADC I
• Jordan Valley Ambulance Service
• Jordan Valley School District #3

• Medical Physician Assistant in Jordan Valley, OR
• Providers in Jordan Valley, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.