Baseline Laboratory Services

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BASELINE LABORATORY SERVICES

Practice address

537 Murphy Rd Ste B
Medford, OR 97504-8187

Phone

(541) 414-0362

Fax

(541) 200-2269

NPI assigned

Apr 13, 2023

Organization subpart

Yes

Parent organization

BASELINE LABORATORY SERVICESAs reported in NPPES

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

Authorized official

Name

Margarita R Moore

Title

Credentialing

Phone

(541) 414-0362

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Southern Oregon Wellness2 organizations share this tax ID, including this one

Part of

Baseline Laboratory Services

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Oregon Wellness Clinic, LLC

  • Primary Care Clinic/Center
  • Medford, OR
  • NPI 1538446315
  NPD tax ID

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1043906985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 E MCANDREWS RD STE D",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045576",
            "telephone_number": "541-414-0362",
            "fax_number": "541-200-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 MURPHY RD STE B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048187",
            "telephone_number": "541-414-0362",
            "fax_number": "541-200-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASELINE LABORATORY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BASELINE LABORATORY SERVICES",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "541-414-0362"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500821822",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "38D2275224",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Bartolome
• Jamie Marie Barton
• Nicholas Bartow Jr., PHARMACIST
• Consuelo Bartyzal, FNP
• Heather Larena Bascom, FNP
• Shaik Iqbal Basha, MD
• Susan Basilicato, NP
• Richard Paul Baska, MS, MFT
• Elizabeth Bastidas, LMT
• Eva Zhouying Batenhorst

• All providers in Medford, OR
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.