NPIMap

Individual provider Active NPI

Laurena Diane Richardson, PA-C

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1306312392
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA207919 Issued in OR
Practice address
70 Bower Dr
Medford, OR 97501-3688
Phone
(541) 732-3430
NPI assigned
Oct 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA207919 OR Primary
Surgical Physician Assistant 363AS0400X PA60997023 WA

Addresses

Primary practice location

70 Bower Dr
Medford, OR 97501-3688

Mailing address

PO Box 31001
Pasadena, CA 91110-4180
Phone (541) 732-8300

Other identifiers 1

IdentifierTypeStateIssuer
500801790MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220110001623 OR Practitioner - Physician Assistant 9335577691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

940 Royal Ave
Medford, OR 97504-6194

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA207919ORMDPhysician Assistant
PA60997023WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 5, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 5, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 5, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 5, 2022 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

1661 Highway 99 N
Ste 100
Ashland, OR 97520
Phone (541) 732-8300

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

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

70 Bower Dr
Medford, OR 97501
Phone (541) 732-8360

Interoperability endpoints

  • Direct secure messaging: laurena.richardson.p16@direct.proliance.nextgenshare.com

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1306312392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104180",
            "telephone_number": "541-732-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BOWER DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013688",
            "telephone_number": "541-732-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LAURENA",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA207919",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60997023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500801790",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.