Individual provider Active NPI

Rebecca Rose, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Medford, OR
National Provider Identifier
1174634794
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
201604566NP Issued in OR
Practice address
221 W Stewart Ave Ste 101
Medford, OR 97501-3609
Phone
(541) 690-3555
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209002787 IL
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 201604566NP OR Primary

Addresses

Primary practice location

221 W Stewart Ave Ste 101
Medford, OR 97501-3609

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160812000240 OR Practitioner - Certified Nurse Midwife (CNM) 2264621119 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica del Valle Family Health Care Center IncGroup PAC ID 0244143089, 59 clinicians

Practice addresses (Care Compare)

221 W Stewart Ave
Medford, OR 97501-3609
Phone (541) 690-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
201604566NPORMDObstetrics & Gynecology Nurse Practitioner
209002787ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas Mills MD LLC CurrentSince May 1, 2025 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
La Clinica del Valle Family Health Care Center Inc. CurrentSince Aug 15, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2016 Accepting new patients
Obhg Oregon PC CurrentSince Jul 1, 2023 Accepting new patients
La Clinica del Valle Family Health Care Center Inc. CurrentSince Aug 15, 2016 Accepting new patients

Locations

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

221 W Stewart Ave
Ste 101
Medford, OR 97501
Phone (541) 690-3500

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

3617 S Pacific Hwy
Medford, OR 97501
Phone (541) 512-3182

2951 Doctors Park Dr
Medford, OR 97504
Phone (541) 200-2646

931 Chevy Way
Medford, OR 97504
Phone (541) 690-3555

Interoperability endpoints

  • Direct secure messaging: rrose189427@direct.ochin.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1174634794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-690-3555",
            "fax_number": "541-512-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W STEWART AVE STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013609",
            "telephone_number": "541-690-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "REBECCA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209002787",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "OR",
            "license": "201604566NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.