NPIMap

Organization Active NPI

Willamette Urology, PC

  • Urology Physician
  • Salem, OR
National Provider Identifier
1467512996
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
WILLAMETTE UROLOGY, PC
Practice address
2973 12TH Street SE
Salem, OR 97302-6162
Phone
(503) 561-7100
Fax
(503) 561-7124
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Dr. John Mark Mhoon, M.D.NPI 1013077510
Title
President
Phone
(503) 561-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X OR Primary

Addresses

Primary practice location

2973 12TH Street SE
Salem, OR 97302-6162

Mailing address

2973 12TH Street SE
Salem, OR 97302-6162
Phone (503) 561-7100

National Provider Directory

National Provider Directory

Locations

591 SE Clay St
Dallas, OR 97338
Phone (503) 561-7100

Practitioners & affiliated clinicians

Practitioners 5

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1467512996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2973 12TH STREET SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026162",
            "telephone_number": "503-561-7100",
            "fax_number": "503-561-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2973 12TH STREET SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026162",
            "telephone_number": "503-561-7100",
            "fax_number": "503-561-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE UROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "MHOON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-561-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "OR",
            "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 Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.