Individual provider Active NPI

Dee Edward Christlieb, M.D.

  • Family Medicine Physician
  • Ashland, OR
National Provider Identifier
1265591622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD12941 Issued in OR
Practice address
935 Siskiyou Blvd
Ashland, OR 97520-2143
Phone
(541) 482-2716
Fax
(541) 488-5461
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD12941 OR Primary

Addresses

Primary practice location

935 Siskiyou Blvd
Ashland, OR 97520-2143

Mailing address

935 Siskiyou Blvd
Ashland, OR 97520-2143
Phone (541) 482-2716

Other identifiers 3

IdentifierTypeStateIssuer
023457000OtherORBCBS
279927MedicaidOR
080003019OtherORRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040730000607 OR Practitioner - Family Practice 5597735068 Practice locations: Ashland, OR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD12941ORMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265591622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 SISKIYOU BLVD",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202143",
            "telephone_number": "541-482-2716",
            "fax_number": "541-488-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 SISKIYOU BLVD",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202143",
            "telephone_number": "541-482-2716",
            "fax_number": "541-488-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTLIEB",
        "first_name": "DEE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD12941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "023457000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279927",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080003019",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.