Organization Active NPI

Salem Free Medical Clinic

  • Clinic/Center
  • Salem, OR
National Provider Identifier
1336456516
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SALEM FREE MEDICAL CLINIC
Practice address
1300 Broadway St NE Suite #104
Salem, OR 97301
Phone
(503) 990-8772
NPI assigned
Sep 9, 2010
Last updated
Sep 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Authorized official

Name
Marie Howard
Title
Administrative Assistant
Phone
(503) 990-8772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1300 Broadway St NE Suite #104
Salem, OR 97301

Mailing address

PO Box 8157
Salem, OR 97303-0251

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D1107648Salem Free Clinics1300 Broadway St NE, Suite 104, Salem, OR 97301Certificate of waiverNov 9, 2027

National Provider Directory

National Provider Directory

Locations

1300 Broadway St NE
Ste 104
Salem, OR 97301
Phone (503) 990-8772

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17725/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1336456516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8157",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973030251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BROADWAY ST NE SUITE #104",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-990-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM FREE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "503-990-8772"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.