WVP INDEPENDENCE MONMOUTH – NPI #1538535059
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

WVP INDEPENDENCE MONMOUTH is an AHC clinic located in INDEPENDENCE, OR. NPPES has assigned the NPI number 1538535059 to WVP INDEPENDENCE MONMOUTH on August 19, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WVP INDEPENDENCE MONMOUTH” is a dba name, the actual legal business name for this organization is WVP MEDICAL GROUP, LLC. The primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 8 years ago on Apr 17, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WVP INDEPENDENCE MONMOUTH below.

NPI Profile for
WVP MEDICAL GROUP, LLC

NPI Number
1538535059
Enumeration Date

(about 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WVP MEDICAL GROUP, LLC
Doing Business As (dba): WVP INDEPENDENCE MONMOUTH
Primary location
1430 MONMOUTH ST
INDEPENDENCE, OR 97351-1127
Phone: (503) 838-1133 Fax: (503) 838-5138
Mailing address
2995 RYAN DR SE STE 200
SALEM, OR 97301-5157
Phone: (503) 371-7701 Fax:
Organization Subpart
Yes - WVP INDEPENDENCE MONMOUTH is subpart of another organization.
Authorized Official
DEAN ANDRETTA
CFO
Phone: (503) 371-7701
Updated
Identifiers

Identifiers for WVP INDEPENDENCE MONMOUTH

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDOR288533
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.