Jordan Personius, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA165526 Issued in OR

Practice address

500 SW Ramsey Ave
Grants Pass, OR 97527-5554

Phone

(541) 789-4281

NPI assigned

Nov 18, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Asante Three Rivers Medical Center LLCGroup PAC ID 9931197993, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Medicare reassignment Care Compare group
• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1013347640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E BARNETT RD",
            "address_2": "SUITE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048344",
            "telephone_number": "541-789-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275554",
            "telephone_number": "541-789-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSONIUS",
        "first_name": "JORDAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA165526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Elizabeth Perkins, QMHP
• Cierra Chree Leeann Perreard
• Eric Matthew Perry, M.D.
• Bradley Personius, MD
• Carol Michelle Personius, O.T.R./L
• Teresa M Persson, MS LPC
• Peter Shelby Bogard DO
• Marla Peters, MD
• Katie Petersen, CPM, LDM
• Paula M Peterson, LMT

• Physician Assistant in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.