Active NPI
Mid Valley Family Physicians
- Family Medicine Physician
- Keizer, OR
National Provider Identifier
1225217995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D025302
- Legal business name
- MID VALLEY FAMILY PHYSICIANS
- Practice address
- 550 Dietz Ave NE
Keizer, OR 97303-4615 - Phone
- (503) 393-0540
- Fax
- (503) 393-3695
- NPI assigned
- Oct 30, 2007
- Organization subpart
- Yes
- Parent organization
- MID VALLEY FAMILY PHYSICIANS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ronald M Palm, DO
- Title
- Physician Owner
- Phone
- (503) 393-0540
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D025302 | OR | Primary |
| Family Medicine Physician | 207Q00000X | D025292 | OR |
Addresses
Primary practice location
550 Dietz Ave NE
Keizer, OR 97303-4615
Mailing address
550 Dietz Ave NE
Keizer, OR 97303-4615
Phone (503) 393-0540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232446 | Medicaid | OR |
National Provider Directory
National Provider Directory- Part of
- Mid Valley Familt Physicians LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Keizer, OR
- NPI 1326174301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1193875200000",
"number": "1225217995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 DIETZ AVE NE",
"city": "KEIZER",
"state": "OR",
"postal_code": "973034615",
"telephone_number": "503-393-0540",
"fax_number": "503-393-3695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 DIETZ AVE NE",
"city": "KEIZER",
"state": "OR",
"postal_code": "973034615",
"telephone_number": "503-393-0540",
"fax_number": "503-393-3695"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MID VALLEY FAMILY PHYSICIANS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MID VALLEY FAMILY PHYSICIANS",
"enumeration_date": "2007-10-30",
"last_updated": "2007-11-01",
"status": "A",
"authorized_official_last_name": "PALM",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "503-393-0540",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OR",
"license": "D025302",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OR",
"license": "D025292",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "232446",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.