Active NPI
William Nisbet, M.D.
- Specialist
- Salem, OR
National Provider Identifier
1750317293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 10771
- Practice address
- 960 Liberty St SE Ste 100
Salem, OR 97302-4165 - Phone
- (503) 364-5033
- Fax
- (503) 364-4820
- NPI assigned
- Jun 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 10771 | OR | Primary |
Addresses
Primary practice location
960 Liberty St SE Ste 100
Salem, OR 97302-4165
Mailing address
960 Liberty St SE Ste 100
Salem, OR 97302-4165
Phone (503) 364-5033
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13769-5 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10771 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1750317293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 LIBERTY ST SE STE 100",
"city": "SALEM",
"state": "OR",
"postal_code": "973024165",
"telephone_number": "503-364-5033",
"fax_number": "503-364-4820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 LIBERTY ST SE STE 100",
"city": "SALEM",
"state": "OR",
"postal_code": "973024165",
"telephone_number": "503-364-5033",
"fax_number": "503-364-4820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISBET",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-25",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "10771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "13769-5",
"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 Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.