Organization Active NPI

Southern Oregon Pediatrics, LLP

  • Pediatric Hospice and Palliative Medicine Physician
  • Medford, OR
National Provider Identifier
1194932814
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X
License
07-00020431 Issued in OR
Legal business name
SOUTHERN OREGON PEDIATRICS, LLP
Practice address
750 Murphy Rd
Medford, OR 97504-8426
Phone
(541) 789-4096
Fax
(541) 789-4073
NPI assigned
May 16, 2007
Last updated
Mar 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Authorized official

Name
Brenda L Sankey
Title
Office Manager
Phone
(541) 789-5879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 07-00020431 OR Primary

Addresses

Primary practice location

750 Murphy Rd
Medford, OR 97504-8426

Mailing address

750 Murphy Rd
Medford, OR 97504-8426
Phone (541) 789-4096

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0627640Southern Oregon Pediatrics750 Murphy Rd, Medford, OR 97504Certificate of waiverMar 14, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1194932814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 MURPHY RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048426",
            "telephone_number": "541-789-4096",
            "fax_number": "541-789-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MURPHY RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048426",
            "telephone_number": "541-789-4096",
            "fax_number": "541-789-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OREGON PEDIATRICS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "SANKEY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-789-5879"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "07-00020431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.