Individual provider Active NPI

Mark Jeremy Nurre, MD

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1144239435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD12335 Issued in OR
Practice address
3750 Chemawa Rd NE
Chemawa Indian Health Center
Salem, OR 97305-1111
Phone
(503) 304-7600
Fax
(503) 304-7677
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD12335 OR Primary
Family Medicine Physician 207Q00000X MD00016941 WA

Addresses

Primary practice location

3750 Chemawa Rd NE
Chemawa Indian Health Center
Salem, OR 97305-1111

Mailing address

3750 Chemawa Rd NE
Salem, OR 97305-1111
Phone (503) 304-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD12335ORMDFamily Medicine Physician
MD00016941WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144239435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051111",
            "telephone_number": "503-304-7600",
            "fax_number": "503-304-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "address_2": "CHEMAWA INDIAN HEALTH CENTER",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051111",
            "telephone_number": "503-304-7600",
            "fax_number": "503-304-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURRE",
        "first_name": "MARK",
        "middle_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD12335",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00016941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; 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.