MR. PAUL DANIEL FICKES (NPI# 1710487897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710487897 |
Entity Type | Individual |
Full Name | MR. PAUL DANIEL FICKES |
Credential | PMHNP-BC |
Practice Address |
2825 E Barnett Rd Medford OR 97504 |
Mailing Address |
744 Forest Hills Dr Rogue River OR 97537-9664 |
Practice Telephone | 5417894222 |
Mailing Telephone | 5413247171 |
Enumeration Date | 2018-02-15 |
Last Update Date | 2018-07-26 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201805705NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | OREGON STATE BOARD OF NURSING | 201805705NP-PP | 01 |
Street Address |
2825 E BARNETT RD |
City | MEDFORD |
State | OR |
Zip Code | 97504 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770587107 | Asante | General Acute Care Hospital | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2005-06-13 |
1497352975 | Angela Kim | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2020-10-07 |
1093330235 | James Allen Garcia | Registered Nurse | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2020-06-13 |
1386283166 | Ruthie Nguyen | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-12-27 |
1235772401 | Michael Lanning | Pharmacy | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-10-21 |
1487295994 | Nicole Mehl | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-10-06 |
1073154191 | Therese Marguerite Wavrin | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-30 |
1063063311 | Kirsten Laity | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-26 |
1790336568 | Shane Vanhandel | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-24 |
1861043663 | Rebecca Ann Kimmel | Pharmacist | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2019-09-23 |
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 | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073147716 | Paradigm Mental Health and Wellness LLC | Nurse Practitioner | 724 S Central Ave Ste 101d, Medford, OR 97501-7808 | 2020-03-02 |
1952860066 | Mcarthur, Gruff & Associates, LLC Dba Carmen Kosicek, Pmhnp | Nurse Practitioner | 1314b Center Dr Unit 439, Medford, OR 97501-7943 | 2019-03-18 |
1811246879 | Deborra M. Torres, Msn, Pmhnp, LLC | Nurse Practitioner | 5 N Main St Ste A, Medford, NJ 08055-2439 | 2012-09-06 |
1518013705 | Susan Wrona | Nurse Practitioner | 14 Cottage St, Medford, OR 97504-7332 | 2007-01-28 |
1558442061 | Pamela Jean Rivera | Nurse Practitioner | 15 Crater Lake Ave, Medford, OR 97504-7444 | 2006-10-18 |
1164538096 | Kevan Joyce Olson | Nurse Practitioner | 255 W Stewart Ave Ste 101, Medford, OR 97501-3600 | 2006-08-22 |
1851325252 | Ruth E Koch | Nurse Practitioner | 31 Industrial Boulevard, Yaphank Center, Medford, NY 11763 | 2006-07-10 |
1174008536 | Connie Diep | Nurse Practitioner | 26 City Hall Mall, Medford, MA 02155-4754 | 2018-10-01 |
1366927220 | Helena Frances Turner | Nurse Practitioner | 900 E Main St, Medford, OR 97504-7136 | 2018-09-26 |
1265927974 | Jatoopon Maldonado | Nurse Practitioner | 31 Scouting Blvd, Medford, NY 11763-2220 | 2018-06-25 |
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.