Jack Vining, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD12819 Issued in OR

Practice address

2700 SE Stratus Ave
McMinnville, OR 97128-6255

Phone

(503) 472-6131

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Albany Emergency Physicians Services, PC

  • Emergency Medicine Physician
  • Albany, OR
  • NPI 1902869472

  Emergency Medicine

  NPD (past)
• Dallas Oregon Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dallas, OR
  • NPI 1659661155

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1922041920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2065",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981112065",
            "telephone_number": "888-828-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286255",
            "telephone_number": "503-472-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINING",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD12819",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD12819",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8378382",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACC",
            "identifier": "JM9451",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "97128A002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDENCE",
            "identifier": "D86802",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L & I",
            "identifier": "0190386",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261156",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "D86802",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XPY185640",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00333023",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Britton Vierboom, DC
• Karmen Vilander, AGNP
• Joel Viles, PA-C
• Ingrid Marika Viljak, DDS
• Jessica Lachman Vincent, PAC
• Stacy Louise Vinson
• Irah May Dela Tina Viola
• Virginia Garcia Memorial Health Center
• Virginia Garcia Memorial Health Center
• Virginia Garcia Memorial Health Center

• All providers in McMinnville, OR
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.