Active NPI
Oregon Advanced Imaging, LLC
- Magnetic Resonance Imaging Radiologic Technologist
- Medford, OR
National Provider Identifier
1134416464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Magnetic Resonance Imaging Radiologic Technologist
- Legal business name
- OREGON ADVANCED IMAGING, LLC
- Practice address
- 881 Ohare Pkwy
Medford, OR 97504-4005 - Phone
- (541) 608-8791
- Fax
- (541) 608-0376
- NPI assigned
- Jul 7, 2011
- Last updated
- Oct 17, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lynette K Gundlach
- Title
- Comptroller
- Phone
- (541) 608-8791
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Computed Tomography Radiologic Technologist | 2471C3401X | |||
| Magnetic Resonance Imaging Radiologic Technologist | 2471M1202X | Primary | ||
| Nuclear Medicine Technology Radiologic Technologist | 2471N0900X |
Addresses
Primary practice location
881 Ohare Pkwy
Medford, OR 97504-4005
Mailing address
PO Box 1527
Medford, OR 97501-0114
Phone (541) 608-8791
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/ | Other | Management Services Network, LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111011000777 | OR | Part B Supplier - Clinic/Group Practice | 3577465376 |
Receives reassigned benefits from 17 practitioners 2 other NPIs on this enrollment Practice locations: Central Point, OR; Medford, OR |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Magnetic Resonance Imaging Radiologic Technologist
- Medford, OR
- NPI 1306133632
O20111011000777
-
- Magnetic Resonance Imaging Radiologic Technologist
- Central Point, OR
- NPI 1689919573
O20111011000777
National Provider Directory
National Provider DirectoryLocations
692 Murphy Rd
Medford, OR 97504
Phone (541) 608-0350
Practitioners & affiliated clinicians
Practitioners 19
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Vascular & Interventional Radiology Physician
- Medford, OR
- NPI 1841435047
-
- Diagnostic Radiology Physician
- Medford, OR
- NPI 1790831386
-
- Diagnostic Radiology Physician
- Medford, OR
- NPI 1225047889
-
- Vascular & Interventional Radiology Physician
- Medford, OR
- NPI 1952543373
-
- Vascular & Interventional Radiology Physician
- Medford, OR
- NPI 1063845709
-
- Diagnostic Radiology Physician
- Medford, OR
- NPI 1891767968
-
- Vascular & Interventional Radiology Physician
- Medford, OR
- NPI 1952515553
-
- Diagnostic Radiology Physician
- Medford, OR
- NPI 1134314537
-
- Diagnostic Radiology Physician
- Medford, OR
- NPI 1124052618
-
- Vascular & Interventional Radiology Physician
- Medford, OR
- NPI 1477895704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792195200000",
"number": "1134416464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1527",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975010114",
"telephone_number": "541-608-8791",
"fax_number": "541-608-0376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "881 OHARE PKWY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044005",
"telephone_number": "541-608-8791",
"fax_number": "541-608-0376"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OREGON ADVANCED IMAGING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-07-07",
"last_updated": "2026-10-17",
"certification_date": "2026-10-17",
"status": "A",
"authorized_official_last_name": "GUNDLACH",
"authorized_official_first_name": "LYNETTE",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "COMPTROLLER",
"authorized_official_telephone_number": "541-608-8791",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "2471C3401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiologic Technologist, Computed Tomography",
"state": null,
"license": null,
"primary": false
},
{
"code": "2471M1202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiologic Technologist, Magnetic Resonance Imaging",
"state": null,
"license": null,
"primary": true
},
{
"code": "2471N0900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiologic Technologist, Nuclear Medicine Technology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/",
"affiliation": "Y",
"endpointDescription": "urn:oid:2.16.840.1.113883.3.1036.1",
"affiliationName": "Management Services Network, LLC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "2357 Warm Springs RD Ste 400",
"city": "Columbus",
"state": "GA",
"country_code": "US",
"postal_code": "319046874",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.