Jeffrey D Disney, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD-23629 Issued in OR

Practice address

1001 Providence Dr
Dept of Emergency Medicine
Newberg, OR 97132-7485

Phone

(503) 537-1785

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary'S Peak Emergency Physicians

  • Emergency Medicine Physician
  • Corvallis, OR
  • NPI 1194733360
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216425600000",
    "number": "1306840822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PROVIDENCE DR",
            "address_2": "DEPT OF EMERGENCY MEDICINE",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327485",
            "telephone_number": "503-537-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PROVIDENCE DR",
            "address_2": "DEPT OF EMERGENCY MEDICINE",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327485",
            "telephone_number": "503-537-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISNEY",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2008-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD-23629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lynn Denniston
• Chelsea Deselms, APRN, FNP-C, CFMP
• Asa Marie Atwater Di Carlo, PA-C
• Lauren Elizabeth Dial
• Joshua Dean Dillard, CRNA
• Susan M Doak, LPC
• Donald W. Skei, D.C., P.C.
• Laura Michelle Donart, SLP
• Todd Doyle, MD
• Dr. Marsha a. Green, L.L.C.

• Emergency Medicine Physician in Newberg, OR
• Providers in Newberg, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.