NPIMap

Organization Active NPI

Urgent Care Clinic South

  • Specialist
  • Salem, OR
National Provider Identifier
1124311550
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD10412 Issued in OR
Legal business name
URGENT CARE CLINIC SOUTH
Practice address
3777 Commercial St SE
Salem, OR 97302-3832
Phone
(503) 588-1234
Fax
(503) 371-8662
NPI assigned
May 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Authorized official

Name
Karleen Rae Kitzmiller
Title
Owner
Phone
(503) 588-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD10412 OR Primary

Addresses

Primary practice location

3777 Commercial St SE
Salem, OR 97302-3832

Mailing address

3777 Commercial St SE
Salem, OR 97302-3832
Phone (503) 588-1234

Other names 1

  • south salem immediate care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1124311550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023832",
            "telephone_number": "503-588-1234",
            "fax_number": "503-371-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023832",
            "telephone_number": "503-588-1234",
            "fax_number": "503-371-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE CLINIC SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "KITZMILLER",
        "authorized_official_first_name": "KARLEEN",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-588-1234"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD10412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "south salem immediate care",
            "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 May 18, 2011; 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.