Active NPI
Patricia A Hedges, RD
- Family Medicine Physician
- Roseburg, OR
National Provider Identifier
1063570463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 885001
- Practice address
- 2371 NE Stephens St Ste 200
Roseburg, OR 97470-1399 - Phone
- (541) 672-8533
- Fax
- (541) 677-5574
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 885001 | OR | Primary |
Addresses
Primary practice location
2371 NE Stephens St Ste 200
Roseburg, OR 97470-1399
Mailing address
539 Hatfield Dr
Roseburg, OR 97470-9409
Phone (541) 672-8533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 165772 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 885001 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063570463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "539 HATFIELD DR",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974709409",
"telephone_number": "541-672-8533",
"fax_number": "541-677-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2371 NE STEPHENS ST STE 200",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974701399",
"telephone_number": "541-672-8533",
"fax_number": "541-677-5574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDGES",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "885001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "165772",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.