SISTERS OF PROVIDENCE IN OREGON (NPI# 1568689701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568689701 |
| Entity Type | Organization |
| Organization Name | SISTERS OF PROVIDENCE IN OREGON |
| Other Organization Name | PMG SOUTH CARDIOVASCULAR SURGERY |
| Practice Address |
940 Royal Ave Suite 450 Medford OR 97504-6193 |
| Mailing Address |
Po Box 3319 Medford OR 97502-0012 |
| Practice Telephone | 5417327850 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-10-30 |
| Authorized Official Name | JOHN JACKSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5417326000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | SISTERS OF PROVIDENCE IN OREGON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RAIL ROAD MEDICARE | CG6801 | 01 |
| Other Name | Type Code |
|---|---|
| PMG SOUTH CARDIOVASCULAR SURGERY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881770808 | Sisters of Providence In Oregon | Clinic/Center | 25 Erickson Avenue, Shady Cove, OR 97539 | 2006-10-31 |
| 1134206790 | Sisters of Providence In Oregon | Clinic/Center | 725 N 5th St, Suite 101, Jacksonville, OR 97530-9873 | 2006-11-01 |
| Street Address |
940 ROYAL AVE SUITE 450 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649250895 | Sanjeev Sharma | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 940 Royal Ave, Suite 450, Medford, OR 97504-6193 | 2006-01-21 |
| 1316358393 | Kevin J Tyndall | Physician Assistant | 940 Royal Ave, Suite 420, Medford, OR 97504-6193 | 2014-05-13 |
| 1750703559 | Jessica Lynn Luckman | Nurse Practitioner | 940 Royal Ave, Ste 350, Medford, OR 97504-6193 | 2014-01-13 |
| 1902193527 | Kendall Lee Olson-cassidy | Registered Nurse | 940 Royal Ave, Suite 350, Medford, OR 97504-6193 | 2011-07-03 |
| 1972896710 | Andrew Galffy | Obstetrics & Gynecology | 940 Royal Ave, Ste 350, Medford, OR 97504-6193 | 2011-05-26 |
| 1578772935 | Aaron Wayne Partsafas | Surgery | 940 Royal Ave, Suite 420, Medford, OR 97504-6194 | 2007-05-22 |
| 1144345455 | Timothy B Hutchings | Obstetrics & Gynecology | 940 Royal Ave, Ste 350, Medford, OR 97504-6193 | 2007-03-20 |
| 1427116862 | Betty Kay Taylor | Advanced Practice Midwife | 940 Royal Ave, Ste 350, Medford, OR 97504-6193 | 2006-12-05 |
| 1750460283 | Providence Health & Services - Oregon | Clinic/Center | 940 Royal Ave, Suite 420, Medford, OR 97504-6193 | 2006-11-03 |
| 1902984263 | John A Schwartz | Surgery | 940 Royal Ave, Suite 420, Medford, OR 97504-6193 | 2006-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | 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). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275157000 | Provident Health Partners Inc. | Clinic/Center | 1529 N Ocean Ave Ste A, Medford, NY 11763-3587 | 2020-06-08 |
| 1427680057 | Ortc, LLC | Clinic/Center | 750 Biddle Rd Ste 102, Medford, OR 97504-6178 | 2020-02-11 |
| 1528543949 | Planned Parenthood of Southwestern Oregon | Clinic/Center | 125 S Central Ave Ste 201, Medford, OR 97501-7222 | 2018-10-02 |
| 1417438359 | Ideal Option, Pllc | Clinic/Center | 216 E Main St Ste 201, Medford, OR 97501-6029 | 2018-08-28 |
| 1750828778 | Regis College | Clinic/Center | 50 Dexter St, 1, Medford, MA 02155-6668 | 2017-01-28 |
| 1629428248 | Southern Oregon Denture & Dental | Clinic/Center | 41 Hawthorne St, Medford, OR 97504-7113 | 2016-06-14 |
| 1881021715 | Oregon Health Sciences University | Clinic/Center | 3192 Arnold Palmer Way, Medford, OR 97504-7773 | 2013-10-10 |
| 1023372067 | Riverside Chiropractic Wellness Centers, Inc | Clinic/Center | 65 Riverside Ave Ste C, Medford, MA 02155-4653 | 2012-06-25 |
| 1497051320 | Northwest Diagnostic Services | Clinic/Center | 2728 W Main St, Suite 121, Medford, OR 97501-2499 | 2011-02-10 |
| 1265745541 | Oregon Internal Medicine, LLC. | Clinic/Center | 2380 W Main St, Suite, A, Medford, OR 97501-2390 | 2010-07-15 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.