Active NPI
Allison Ehrlich
- Physician Assistant
- Myrtle Point, OR
National Provider Identifier
1083955199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA169624
- Practice address
- 324 4TH St
Myrtle Point, OR 97458-1066 - Phone
- (541) 572-2111
- Fax
- (541) 572-5743
- NPI assigned
- Mar 14, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | PA169624 | OR | Primary |
Addresses
Primary practice location
324 4TH St
Myrtle Point, OR 97458-1066
Mailing address
324 4TH St
Myrtle Point, OR 97458-1066
Phone (541) 572-2111
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407812365 | Other | OR | GROUP NPI NORTH BEND MEDICAL CENTER |
| 161133 | Other | OR | GROUP DMAP NORTH BEND MEDICAL CENTER |
| 500676697 | Medicaid | OR | |
| R0000WFBTV | Other | OR | GROUP MEDICARE NORTH BEND MEDICAL CENTER |
| P01411693 | Other | OR | RAILROAD MEDICARE |
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA169624 | OR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425600000000",
"number": "1083955199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 4TH ST",
"city": "MYRTLE POINT",
"state": "OR",
"postal_code": "974581066",
"telephone_number": "541-572-2111",
"fax_number": "541-572-5743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 4TH ST",
"city": "MYRTLE POINT",
"state": "OR",
"postal_code": "974581066",
"telephone_number": "541-572-2111",
"fax_number": "541-572-5743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHRLICH",
"first_name": "ALLISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-14",
"last_updated": "2015-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA169624",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI NORTH BEND MEDICAL CENTER",
"identifier": "1407812365",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP DMAP NORTH BEND MEDICAL CENTER",
"identifier": "161133",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500676697",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE NORTH BEND MEDICAL CENTER",
"identifier": "R0000WFBTV",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01411693",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Point, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.