NPIMap

Organization Active NPI

Salem Clinic, PC

  • General Practice Physician
  • Salem, OR
National Provider Identifier
1912935594
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SALEM CLINIC, PC
Practice address
2020 Capitol St NE
Salem, OR 97303-3244
Phone
(503) 399-2470
Fax
(503) 375-7429
NPI assigned
Jun 30, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ms. Barbara Gunder, CAO
Title
Administrator/Cao
Phone
(503) 399-2470

Practitioners 128

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

View all 128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040430000150 OR Part B Supplier - Clinic/Group Practice 7517954514 Receives reassigned benefits from 124 practitioners
Practice locations: Keizer, OR; Salem, OR
O20100930053228 OR DME Supplier - Multi-Specialty - Physician 7517954514 Practice locations: Salem, OR

National Provider Directory

National Provider Directory

Locations

5900 Inland Shores Way N
Ste 100
Keizer, OR 97303

3494 Liberty Rd S
Salem, OR 97302
Phone (503) 385-8361

665 Winter St SE
Ste B
Salem, OR 97301

1174 Cornucopia St NW
Ste 120
Salem, OR 97304

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

2020 Capitol St NE
Salem, OR 97303-3244

Mailing address

PO Box 8100
Salem, OR 97303-0900
Phone (503) 399-2470

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
500400275MedicaidOR
179051MedicaidOR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 6, 2016.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1912935594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973030900",
            "telephone_number": "503-399-2470",
            "fax_number": "503-375-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973033244",
            "telephone_number": "503-399-2470",
            "fax_number": "503-375-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "GUNDER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "ADMINISTRATOR/CAO",
        "authorized_official_telephone_number": "503-399-2470",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CAO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500400275",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179051",
            "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 6, 2016; 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.