NPIMap

Organization Active NPI

Valley Immediate Care, LLC

  • Non-Pharmacy Dispensing Site
  • Grants Pass, OR
National Provider Identifier
1821504192
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
MD24585 Issued in OR
Legal business name
VALLEY IMMEDIATE CARE, LLC
Practice address
162 NE Beacon Dr Ste 103
Grants Pass, OR 97526-4260
Phone
(541) 734-9030
Fax
(541) 734-9885
NPI assigned
Dec 21, 2017
Last updated
Dec 21, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
VALLEY IMMEDIATE CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Authorized official

Name
Diana K Doran
Title
Cfo
Phone
(541) 734-9030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X MD24585 OR Primary

Addresses

Primary practice location

162 NE Beacon Dr Ste 103
Grants Pass, OR 97526-4260

Mailing address

815 N Central Ave Ste C
Medford, OR 97501-5873

Other names 1

  • Valley Immediate Care Other name

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
38D1072984Valley Immediate Care, LLC Grants Pass162 NE Beacon Dr Suite 103, Grants Pass, OR 97526ComplianceJan 27, 2028

National Provider Directory

National Provider Directory
Tax ID family
Valley Immediate Care LLC4 organizations share this tax ID, including this one
Part of
Valley Immediate Care LLC

Other organizations with this tax ID 3

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

Locations

815 N Central Ave
Ste C
Medford, OR 97501
Phone (541) 734-9030

Practitioners & affiliated clinicians

Practitioners 12

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": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513814400000",
    "number": "1821504192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N CENTRAL AVE STE C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 NE BEACON DR STE 103",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975264260",
            "telephone_number": "541-734-9030",
            "fax_number": "541-734-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY IMMEDIATE CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VALLEY IMMEDIATE CARE LLC",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A",
        "authorized_official_last_name": "DORAN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "541-734-9030"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "OR",
            "license": "MD24585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Immediate Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.