Marion Polk Community Health Plan Advantage, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.

Practice address

245 Commercial St SE Ste 220
Salem, OR 97301-3466

Phone

(503) 371-7701

Fax

(503) 485-3224

NPI assigned

Jan 6, 2009

Organization subpart

Yes

Parent organization

MVIPAAs reported in NPPES

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

Authorized official

Name

Mr. Dean Andretta

Title

Cfo

Phone

(503) 587-5107

Specialties & licenses 1

Addresses

Other names 1

• MPCHP Advantage Other name

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1508002973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 COMMERCIAL ST SE STE 220",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013466",
            "telephone_number": "503-371-7701",
            "fax_number": "503-485-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 COMMERCIAL ST SE STE 220",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013466",
            "telephone_number": "503-371-7701",
            "fax_number": "503-485-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MVIPA",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "ANDRETTA",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "503-587-5107",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MPCHP Advantage",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marion County Health Department
• Marion County Health Department
• Marion County Health Dept
• Marion County Juvenile Department
• Marion County School District 24J
• Marion Polk Community Health Plan, LLC.
• Marion-Polk Food Share
• Mark T. Gabr, M.D., P.C.
• Julissa Mark
• Aidan Marker-Fischer

• Health Maintenance Organization in Salem, OR
• Providers in Salem, OR by specialty
• Health Maintenance Organization in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.