Individual provider Active NPI

Lauralyn Brooke Carter-Meletich, DO

  • Family Medicine Physician
  • Medford, OR
National Provider Identifier
1053577122
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO28569 Issued in OR
Practice address
3617 S Pacific Hwy
Medford, OR 97501-8957
Phone
(541) 535-6239
Fax
(541) 512-1027
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO28569 OR Primary

Addresses

Primary practice location

3617 S Pacific Hwy
Medford, OR 97501-8957

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Other practice location 1

201 S Mountain Ave
Ashland, OR 97520-2165
Phone (541) 535-6239

Other practice location 2

1955 Scenic Ave
Central Point, OR 97502-1652
Phone (541) 535-6239

Other identifiers 1

IdentifierTypeStateIssuer
DO28569OtherORMEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080818000664 OR Practitioner - Family Practice 8820163306 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO28569ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica del Valle Family Health Care Center Inc. CurrentSince Jun 9, 2017 Accepting new patients
La Clinica del Valle Family Health Care Center Inc. Past Accepting new patients

Locations

201 S Mountain Ave
Ashland, OR 97520
Phone (541) 842-7677

931 Chevy Way
Medford, OR 97504
Phone (541) 690-3555

910 S Central Ave
Medford, OR 97501
Phone (541) 618-1380

3617 S Pacific Hwy
Medford, OR 97501
Phone (541) 512-3182

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1053577122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-690-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Mountain Ave",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "OR",
            "postal_code": "975202165",
            "country_code": "US",
            "telephone_number": "541-535-6239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1955 Scenic Ave",
            "address_purpose": "LOCATION",
            "city": "Central Point",
            "state": "OR",
            "postal_code": "975021652",
            "country_code": "US",
            "telephone_number": "541-535-6239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER-MELETICH",
        "first_name": "LAURALYN",
        "middle_name": "BROOKE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO28569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "DO28569",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.