Individual provider Active NPI

Patricia A Hedges, RD

  • Family Medicine Physician
  • Roseburg, OR
National Provider Identifier
1063570463
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
885001 Issued in OR
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

Updated by the provider on Jul 8, 2007

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 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

IdentifierTypeStateIssuer
165772MedicaidOR

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

LicenseStateTypeSpecialty
885001ORMDFamily 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.

Verify at the official NPI Registry.