Vida Family Medicine

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201402104-NP-PP Issued in OR

Legal business name

VIDA FAMILY MEDICINE

Practice address

374 Owens St SE
Salem, OR 97302-4183

Phone

(503) 399-1400

Fax

(503) 399-1406

NPI assigned

Mar 28, 2016

Organization subpart

No

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

Authorized official

Name

Teri Litke

Title

Administrator

Phone

(503) 399-1400

Specialties & licenses 5

Addresses

Other names 1

• Vida Integrative Medicine & Mental Health Doing business as

Practitioners 1

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

• Evelin Dacker, M.D.

  • Family Medicine Physician
  • Salem, OR
  • NPI 1861479396
  NPD (past)

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1184086209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 883",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973080883",
            "telephone_number": "503-399-1400",
            "fax_number": "503-399-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 OWENS ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024183",
            "telephone_number": "503-399-1400",
            "fax_number": "503-399-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "LITKE",
        "authorized_official_first_name": "TERI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-399-1400"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "07-12-12",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L6901",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0986",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0889",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201402104-NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vida Integrative Medicine & Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vibrance Physical Therapy LLC
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• Lorelie Vicente
• Vicki L Seller,M.D.,P.C.
• Vickie Haneberg Ma LPC LLC
• Vida Family Medicine, LLC
• Jacob Thomas Vida
• Gary W Viehdorfer, LMT
• Stacey Nicole Vieyra-Braendle, OTD, OTR/L, MT-BC
• Savannah Vigue

• Psychiatric/Mental Health Nurse Practitioner in Salem, OR
• Providers in Salem, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.