Organization Active NPI

Wellbe Oregon PC

  • Internal Medicine Physician
  • Salem, OR
National Provider Identifier
1710678537
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLBE OREGON PC
Practice address
3535 Del Webb Ave NE Ste 120
Salem, OR 97301-7499
Phone
(855) 445-9520
Fax
(971) 353-4148
NPI assigned
May 15, 2023
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Dr. Jeffrey Kang, MDNPI 1710429410
Title
Ceo
Phone
(312) 855-4851

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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3535 Del Webb Ave NE Ste 120
Salem, OR 97301-7499

Mailing address

225 W Washington St Ste 1700
Chicago, IL 60606-3404

Other practice location 1

225 W Washington St Ste 1500
Chicago, IL 60606-3485
Phone (855) 445-9520

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719000249 OR Part B Supplier - Clinic/Group Practice 0547620866 Receives reassigned benefits from 3 practitioners
Practice locations: Salem, OR

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
38D2322689Wellbe Oregon PC3535 Del Webb Ave NE, Suite 120, Salem, OR 97301Certificate of waiverApr 23, 2027

National Provider Directory

National Provider Directory

Locations

225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220

3535 Del Webb Ave NE
Ste 120
Salem, OR 97301
Phone (855) 445-9520

Practitioners & affiliated clinicians

Practitioners 3

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": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1710678537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W WASHINGTON ST STE 1700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 DEL WEBB AVE NE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017499",
            "telephone_number": "855-445-9520",
            "fax_number": "971-353-4148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 W Washington St Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606063485",
            "country_code": "US",
            "telephone_number": "855-445-9520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLBE OREGON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-855-4851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "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 Sep 26, 2024; 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.