David T Elmgren, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD07578 Issued in OR

Practice address

2973 12TH Street SE
Salem, OR 97302-6162

Phone

(503) 561-7100

Fax

(503) 561-7124

NPI assigned

Dec 12, 2006

Last updated

Feb 27, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Willamette Urology, PC

  • Urology Physician
  • Salem, OR
  • NPI 1467512996
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1598826851",
    "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": {
        "last_name": "ELMGREN",
        "first_name": "DAVID",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD07578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234658",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordyn R Ellis, CHW
• Katelynn Anne Ellis
• Robin Ellison
• William Blount Ellison III, MD
• Joshua Elliston, BS
• Scott Keith Elmore, PSYD
• Corinne Ilene Elms, LPC
• Alice Elroy, MD
• Katrina Elser Casas, CRM, PRC
• Hadya Elshakh, MD

• Urology Physician in Salem, OR
• Providers in Salem, OR by specialty
• Urology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.