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PEACEHEALTH MEDICAL GROUP NPI 1447207287


NPI Information

NPI: 1447207287
Provider Name: PEACEHEALTH MEDICAL GROUP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 38D2136818

Address:
1200 HILYARD ST
EUGENE, OR
ZIP 97401
Phone: (541) 687-6217
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PEACEHEALTH MEDICAL GROUP is a family medicine in Eugene, OR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PEACEHEALTH MEDICAL GROUP NPI is 1447207287. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1200 HILYARD ST
EUGENE, OR
ZIP 97401-122
Phone: (541) 687-6217

The provider's authorized official is Lori Kettler .
The authorized official title is Provider Enrollment Lead and has the following contact phone number (360) 729-1411.

The CLIA number assigned to this NPI record is 38D2136818 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/27/2006 and was last updated on 4/4/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineOREGONNo
2208000000XPediatricsOKLAHOMANo
32084A0401XPsychiatry & NeurologyAddiction MedicineOREGONNo
4208600000XSurgeryOREGONNo
52084P0800XPsychiatry & NeurologyPsychiatryOREGONNo
6101Y00000XCounselorOREGONNo
7101YM0800XCounselorMental HealthOREGONNo
8106H00000XMarriage & Family TherapistOREGONNo
9103T00000XPsychologistOREGONNo
10104100000XSocial WorkerOREGONNo
111041C0700XSocial WorkerClinicalOREGONNo
12133V00000XDietitian, RegisteredOREGONNo
13367A00000XAdvanced Practice MidwifeOREGONNo
14261QM1300XClinic/CenterMulti-SpecialtyOREGONNo
15207Q00000XFamily MedicineOREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1071634MEDICAIDOREGON
2R0000WFBFRMEDICARE PINOREGON
31042230009MEDICARE NSCOREGON
4CC7625MEDICARE PINOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.