Organization Active NPI

Siskiyou Anestesia Group,LLC

  • Specialist
  • Medford, OR
National Provider Identifier
1336424050
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SISKIYOU ANESTESIA GROUP,LLC
Practice address
2925 Siskiyou Blvd
Medford, OR 97504-8179
Phone
(541) 488-7715
Fax
(541) 488-5885
NPI assigned
Oct 13, 2011
Last updated
Oct 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Shawn M Sills, M.D.
Title
Owner
Phone
(541) 488-7715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

2925 Siskiyou Blvd
Medford, OR 97504-8179

Mailing address

2925 Siskiyou Blvd
Medford, OR 97504-8179
Phone (541) 488-7715

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1336424050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 SISKIYOU BLVD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048179",
            "telephone_number": "541-488-7715",
            "fax_number": "541-488-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 SISKIYOU BLVD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048179",
            "telephone_number": "541-488-7715",
            "fax_number": "541-488-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISKIYOU ANESTESIA GROUP,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "SILLS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-488-7715",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "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 Oct 13, 2011; 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.