NPIMap

Organization Active NPI

Willamette Family Medical Center Inc

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1649386418
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLAMETTE FAMILY MEDICAL CENTER INC
Practice address
435 Lancaster Dr NE
Salem, OR 97301
Phone
(503) 585-6388
Fax
(503) 566-0212
NPI assigned
Aug 22, 2006
Last updated
Jun 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Authorized official

Name
Dr. Robert Steele, MDNPI 1265548036
Title
Ceo
Phone
(503) 585-6388

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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

435 Lancaster Dr NE
Salem, OR 97301

Mailing address

435 Lancaster Dr NE
Salem, OR 97301-4729
Phone (503) 585-6388

Other identifiers 2

IdentifierTypeStateIssuer
89055000OtherORBCBS
230452MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040402000465 OR Part B Supplier - Clinic/Group Practice 0749272201 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
Practice locations: Salem, OR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0903686Willamette Family Medical Center Lab435 Lancaster Dr NE, Salem, OR 97301Provider-performed microscopyDec 31, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1649386418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014729",
            "telephone_number": "503-585-6388",
            "fax_number": "503-566-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-585-6388",
            "fax_number": "503-566-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "STEELE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-585-6388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89055000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230452",
            "state": "OR"
        }
    ],
    "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 Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.