Fitzgerald Family Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2015011081 Issued in OR

Legal business name

FITZGERALD FAMILY MEDICINE

Practice address

289 E Ellendale Ave Ste 602
Dallas, OR 97338-1570

Phone

(971) 612-1588

Fax

(503) 831-3215

NPI assigned

May 6, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Erin Sanford Fitzgerald, FNP-BCNPI 1306217872

Title

Nurse Practitioner

Phone

(971) 612-1588

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erin Sanford Fitzgerald, FNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln City, OR
  • NPI 1306217872
  NPD Authorized official

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

{
    "created_epoch": "1525564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525564800000",
    "number": "1255820239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W ELLENDALE AVE STE 103",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381456",
            "telephone_number": "971-612-1588",
            "fax_number": "503-831-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 E ELLENDALE AVE STE 602",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381570",
            "telephone_number": "971-612-1588",
            "fax_number": "503-831-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZGERALD FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-06",
        "last_updated": "2018-05-06",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "SANFORD",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "971-612-1588",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "2015011081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Scott Fahlman
• Family Connects Oregon
• Shoshana Farber, WHNP
• Adam Jeffrey Fergus
• Fir Hill Group Home LLC
• Flaming Medical Center P.C.
• Tom L Flaming, D.O.
• Isabella Fleener
• David Flynn, LPCI, QMHP
• Frances Marie Forsythe

• Primary Care Clinic/Center in Dallas, OR
• Providers in Dallas, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.