NPIMap

Organization Active NPI

PPC Group LLC

Doing business as Prevention Plus Clinic

  • Primary Care Clinic/Center
  • Springfield, OR
National Provider Identifier
1508190661
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD23479 Issued in OR
Legal business name
PPC GROUP LLC
Doing business as
Prevention Plus Clinic
Practice address
1800 Centennial Blvd
Suite #6
Springfield, OR 97477-4385
Phone
(541) 726-2179
NPI assigned
Sep 22, 2009
Last updated
Oct 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Authorized official

Name
Alison Erde, MDNPI 1760434385
Title
Sole Member
Phone
(541) 726-1865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD23479 OR Primary

Addresses

Primary practice location

1800 Centennial Blvd
Suite #6
Springfield, OR 97477-4385

Mailing address

1800 Centennial Blvd
6
Springfield, OR 97477-4385
Phone (541) 726-2179

Other names 1

  • Prevention Plus Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091125000080 OR Part B Supplier - Clinic/Group Practice 4789723115 Receives reassigned benefits from 2 practitioners
Practice locations: Eugene, OR

National Provider Directory

National Provider Directory

Locations

3225 Willamette St
Ste 1
Eugene, OR 97405
Phone (541) 686-9715

1800 Centennial Blvd
Ste 6
Springfield, OR 97477
Phone (503) 726-1865

1800 Centennial Blvd
#6
Springfield, OR 97477
Phone (541) 726-1865

Practitioners & affiliated clinicians

Practitioners 7

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": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1508190661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 CENTENNIAL BLVD",
            "address_2": "6",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774385",
            "telephone_number": "541-726-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CENTENNIAL BLVD",
            "address_2": "SUITE #6",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774385",
            "telephone_number": "541-726-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "ERDE",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "541-726-1865",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "MD23479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prevention Plus Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.