John Arthur Enbom, M.D.

Primary specialty

Critical Care Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VC0200X

License

MD07110 Issued in OR

Practice address

2625 SW Brooklane Dr
Corvallis, OR 97333-1513

Phone

(541) 757-9614

Fax

(541) 752-7030

NPI assigned

Feb 24, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1912271735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 SW BROOKLANE DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331513",
            "telephone_number": "541-757-9614",
            "fax_number": "541-752-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 SW BROOKLANE DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331513",
            "telephone_number": "541-757-9614",
            "fax_number": "541-752-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENBOM",
        "first_name": "JOHN",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VC0200X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Critical Care Medicine",
            "state": "OR",
            "license": "MD07110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerald Care LLC
• Emerald National Laboratory LLC
• Teena Emerson
• Jaden Emminger
• Christine L. Emmons, RNFA
• Kevin Endo
• Aleea Jewel Enfield
• Braden Jeffrey Enfield, RPH
• Nicolene Engelbrecht, RPH
• Judy Ann Engelking, LCSW

• Obstetrics & Gynecology Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Obstetrics & Gynecology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.

Verify at the official NPI Registry.