Heather Larena Bascom, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10021529 Issued in OR

Practice address

2825 E Barnett Rd
Medford, OR 97504-8332

Phone

(541) 789-7000

NPI assigned

Oct 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Utah Medical GroupGroup PAC ID 2961496609, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uintah Basin Medical Center Hospital, Roosevelt, UT, CCN 460019
• Ashley Regional Medical Center Hospital, Vernal, UT, CCN 460030

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccq3348@yourcarecommunity.org

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.

• Northeastern Utah Medical Group

  • Family Medicine Physician
  • Roosevelt, UT
  • NPI 1982664199

  UT

  Medicare reassignment Care Compare group
• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107

  OR

  Medicare reassignment NPD
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809

  OR

  Medicare reassignment NPD
• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Roosevelt, UT
  • NPI 1871556217

  UT

  Medicare reassignment
• Northeastern Utah Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Roosevelt, UT
  • NPI 1740482009
  Care Compare group
• Asante

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• High Desert Neurology of Utah, PC

  • Neurology Physician
  • Vernal, UT
  • NPI 1720779416
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ashley Valley Medical Center LLC

  • General Acute Care Hospital
  • Vernal, UT
  • NPI 1447296249

  Hospital

  Care Compare affiliation
• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Roosevelt, UT
  • NPI 1871556217

  Hospital

  Care Compare affiliation
• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Vernal, UT
  • NPI 1881447571

  Hospital

  Care Compare affiliation
• Uintah Basin Medical Center

  • Physical Therapy Clinic/Center
  • Ballard, UT
  • NPI 1912750662

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1124660154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCOM",
        "first_name": "HEATHER",
        "middle_name": "LARENA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "362422-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "362422-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10021529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Bartley
• David Bartolome
• Jamie Marie Barton
• Nicholas Bartow Jr., PHARMACIST
• Consuelo Bartyzal, FNP
• Baseline Laboratory Services
• Shaik Iqbal Basha, MD
• Susan Basilicato, NP
• Richard Paul Baska, MS, MFT
• Elizabeth Bastidas, LMT

• All providers in Medford, OR
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.