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...
ID license #M-15457OR license #MD125936taxonomy 207Q00000X
Identifiers
Type
Value
Notes
05 (OR)
500608912
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Medicare directory context
Attributes below come from the CMS Doctors & Clinicians dataset used by Medicare Care Compare,
retrieved 2026-08-21. They apply only to this clinician's public Medicare listing.
Medicare specialties
Family Practice
Largest Medicare group
673 members
Largest listed enrollment group
Facility affiliations reported by CMS
Saint Alphonsus Regional Medical Center Inc
Medicare listing data does not guarantee that a clinician is accepting new patients or that a service is covered.
View the CMS dataset →
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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