Oak Street Medical P.C.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

OAK STREET MEDICAL P.C.

Practice address

1488 Oak St
Eugene, OR 97401-4043

Phone

(541) 683-1577

Fax

(541) 344-6176

NPI assigned

Aug 22, 2005

Organization subpart

No

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

Authorized official

Name

Kraig Warren Jacobson, M.D.

Title

Physician / Owner

Phone

(541) 683-1577

Specialties & licenses 2

Addresses

Other names 1

• Oregon Allergy Associates Doing business as

Locations

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1144212499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014043",
            "telephone_number": "541-683-1577",
            "fax_number": "541-344-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014043",
            "telephone_number": "541-683-1577",
            "fax_number": "541-344-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK STREET MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "KRAIG",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "541-683-1577",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Allergy Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia O'Neil, RD
• Phyllis O'Neill, LCSW
• Connor O'Shea
• Oak & Pine Family Group
• Oak Street Medical
• Jodi Denise Oakerson
• Oakmont Kids Pediatric Dentistry PC
• Oasis Mental Health PC
• Shelby L Oberg
• Oria Gynnette Oberholtzer

• Allergy & Immunology Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Allergy & Immunology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.