Junction City Medical Clinic, P.C.

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

MD14262 Issued in OR

Legal business name

JUNCTION CITY MEDICAL CLINIC, P.C.

Practice address

355 W 3Rd Ave
Junction City, OR 97448-1313

Phone

(541) 998-6750

NPI assigned

Mar 19, 2008

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Part of

Tri - State Medical Group Inc

Locations

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1104097054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 3RD AVE",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974481313",
            "telephone_number": "541-998-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNCTION CITY MEDICAL CLINIC, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2008-03-19",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "OR",
            "license": "MD14262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A Johnson, COTA/L
• Christina Flynn Johnston, LMFT
• Alicia M Jones
• Cornelius Jones
• Jeanette Irene Jonk
• Junction City of Cascadia, LLC
• Junction City Rehabilitation, Inc.
• Junction City Rehabilitation, LLC
• Junction City School District # 69
• Jordan Faith Karg

• Non-Pharmacy Dispensing Site in Junction City, OR
• Providers in Junction City, OR by specialty
• Non-Pharmacy Dispensing Site in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.