Elysian Health

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

201604728NP Issued in OR

Legal business name

ELYSIAN HEALTH

Practice address

835 Crater Lake Ave
Medford, OR 97504-6505

Phone

(541) 507-4141

NPI assigned

Mar 17, 2017

Organization subpart

No

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

Authorized official

Name

Gabrielle Fey

Title

Owner

Phone

(541) 507-4141

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1013458405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 WILLIAMS HWY",
            "address_2": "STE 39",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275660",
            "telephone_number": "541-507-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046505",
            "telephone_number": "541-507-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSIAN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "GABRIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-507-4141"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201604728NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Elliott
• Rebecca Elizabeth Elliott, D.O.
• Amee Alene Ellis, OTL
• Wendy N Ellison, RD, RDN
• Rebecca Irene Elston
• Elizabeth Roya Emami, M.D.
• Michael Emanuel
• Ingrid Emata
• Lisa Emery, MA
• Emory E. Hamilton DMD

• Adult Health Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.