NPIMap

Organization Active NPI

Salem Womens Clinic, Inc

  • Obstetrics & Gynecology Physician
  • Salem, OR
National Provider Identifier
1760415202
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SALEM WOMENS CLINIC, INC
Practice address
1395 Liberty St SE
Salem, OR 97302-4276
Phone
(503) 399-2444
Fax
(503) 581-3960
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Elizebeth R. Harmon, M.D.NPI 1487688396
Title
Owner
Phone
(503) 399-2444

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X OR
Family Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SF0001X OR
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X OR

Addresses

Primary practice location

1395 Liberty St SE
Salem, OR 97302-4276

Mailing address

1395 Liberty St SE
Salem, OR 97302-4276
Phone (503) 399-2444

Other identifiers 1

IdentifierTypeStateIssuer
286300MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429001581 OR Part B Supplier - Clinic/Group Practice 3870580848 Receives reassigned benefits from 1 practitioner
Practice locations: Salem, OR

National Provider Directory

National Provider Directory
Tax ID family
Salem Womens Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1395 Liberty St SE
Ste 2
Salem, OR 97302

1395 Liberty St SE
Salem, OR 97302
Phone (503) 399-2444

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1760415202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024276",
            "telephone_number": "503-399-2444",
            "fax_number": "503-581-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024276",
            "telephone_number": "503-399-2444",
            "fax_number": "503-581-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM WOMENS CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "HARMON",
        "authorized_official_first_name": "ELIZEBETH",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-399-2444",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286300",
            "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 Oct 1, 2012; 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.