Julia Esther Balcom, MN,BSN
Individual provider Active NPI Family Nurse Practitioner · Dallas, OR
NPI 1194153494 · NPPES record last updated Sep 10, 2021
Key facts
- NPI
- 1194153494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 201391421NP-PP (OR)
- Practice address
- 531 SE Clay St
Dallas, OR 97338-2865 - Phone
- (971) 612-6100
- Fax
- (971) 612-6101
- NPI assigned
- Oct 23, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Praxis Health PC
Practice addresses (Care Compare)
929 SW Simpson Ave
Bend, OR 97702-3599
Phone (541) 389-7741
Hospital & facility affiliations
- Salem Health West Valley
- Salem Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140221000392 | OR | Practitioner - Nurse Practitioner | 1557591427 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201391421NP-PP | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Praxis Health, PC | Family | Current |
Accepting new patients |
| Praxis Health, PC | Current |
Accepting new patients |
Locations
929 SW Simpson Ave
Bend, OR 97702
Phone (541) 848-6642
531 SE Clay St
Dallas, OR 97338
Phone (503) 623-5430
4999 Skyline Rd S
Ste 100
Salem, OR 97306
Phone (503) 364-4005
Interoperability endpoints
- jbalcom237704@direct.salemhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 201391421NP-PP | OR | Yes |
Addresses
Primary practice location
531 SE Clay St
Dallas, OR 97338-2865
Mailing address
PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119
Other names
- Julia Esther Thomas
Other providers in Dallas, OR
- Justin Babcock
- Jamie Bagley
- Lauren Hillary Bain
- Linnea Baker
- Nancy Jean Baker
- Thomas Balcom
- Anna Lee Balkema
- J Rebecca Barden
- John L Barringer
- Kaylee Bartnes
All providers in Dallas, OR · Family Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.