Individual provider Active NPI

Alice So, MD

  • Hospitalist Physician
  • Springfield, OR
National Provider Identifier
1407968431
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD174884 Issued in OR
Practice address
3377 Riverbend Dr
Springfield, OR 97477-8803
Phone
(541) 222-6389
Fax
(541) 222-6385
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 13564 NH
Hospitalist Physician 208M00000X MD174884 OR Primary
Internal Medicine Physician 207R00000X 13564 NH

Addresses

Primary practice location

3377 Riverbend Dr
Springfield, OR 97477-8803

Mailing address

44 Birch St
Suite 201
Derry, NH 03038-2752
Phone (603) 421-2384

Other practice location 1

1 Parkland Dr
Derry, NH 03038-2746
Phone (603) 421-2384

Other identifiers 1

IdentifierTypeStateIssuer
30206568MedicaidNH

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
I20160201001308 OR Practitioner - HospitalistPractitioner - Internal Medicine 0345345781 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

2801 NW Mercy Dr
Suite 350
Roseburg, OR 97471-2349
Phone (541) 222-2700

3311 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7218

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7300

3355 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6113

Hospital & facility affiliations

  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Physician Services LLC CurrentSince Dec 28, 2015 Accepting new patients
Peacehealth Current Accepting new patients
Peacehealth Hospitalist CurrentSince Jan 6, 2020 Accepting new patients
Vibra Physicians LLC Hospitalist CurrentSince May 1, 2019 Accepting new patients
Peacehealth CurrentSince Feb 28, 2022 Accepting new patients
Peacehealth Past Accepting new patients
Parkland Physician Services Inc Past Accepting new patients

Locations

1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333

400 9th St
Florence, OR 97439
Phone (541) 997-8412

10300 NE Hancock St
Portland, OR 97220
Phone (503) 257-5500

2801 NW Mercy Dr
Ste 350
Roseburg, OR 97471
Phone (541) 222-2700

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Interoperability endpoints

  • Direct secure messaging: aso428181@direct.peacehealth.org
  • Direct secure messaging: aso062@yourcarecommunity.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1407968431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST",
            "address_2": "SUITE 201",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752",
            "telephone_number": "603-421-2384",
            "fax_number": "603-421-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-6389",
            "fax_number": "541-222-6385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Parkland Dr",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030382746",
            "country_code": "US",
            "telephone_number": "603-421-2384",
            "fax_number": "603-421-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SO",
        "first_name": "ALICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NH",
            "license": "13564",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD174884",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "13564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30206568",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.