Individual provider Active NPI

Kaitlin Eileen Stapleton, FNP

  • Nurse Practitioner
  • Medford, OR
National Provider Identifier
1033636279
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201707765NP-PP Issued in OR
Practice address
3270 Hillcrest Road
Medford, OR 97504
Phone
(541) 779-1672
NPI assigned
Aug 28, 2017
Last updated
Jun 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201707765NP-PP OR Primary

Addresses

Primary practice location

3270 Hillcrest Road
Medford, OR 97504

Mailing address

2900 State St
Medford, OR 97504-8458
Phone (541) 779-1672

Other practice location 1

2900 State St
Medford, OR 97504-8458
Phone (541) 779-1672

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171018000073 OR Practitioner - Nurse Practitioner 8426324559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oregon Neurosurgical and Spine Associates, PCGroup PAC ID 8022275684, 11 clinicians

Practice addresses (Care Compare)

2900 State St
Medford, OR 97504-8458
Phone (541) 779-1672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201707765NP-PPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Neurosurgical & Spine Associates, PC CurrentSince Oct 16, 2017 Accepting new patients

Locations

2900 State St
Medford, OR 97504
Phone (541) 779-1672

3270 Hillcrest Rd
Medford, OR 97504
Phone (541) 779-1672

Organizations & group practices 1

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

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1033636279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048458",
            "telephone_number": "541-779-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 HILLCREST ROAD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-779-1672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 State St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048458",
            "country_code": "US",
            "telephone_number": "541-779-1672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "KAITLIN",
        "middle_name": "EILEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2025-06-06",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201707765NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.