John Calvin Green-Haudenshild

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

1301 W Stewart Ave
Unit 1
Medford, OR 97501

Phone

(541) 261-8061

NPI assigned

Jan 11, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1336890458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E MAIN ST",
            "city": "ROGUE RIVER",
            "state": "OR",
            "postal_code": "975379419",
            "telephone_number": "541-678-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W STEWART AVE",
            "address_2": "UNIT 1",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97501",
            "telephone_number": "541-261-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN-HAUDENSHILD",
        "first_name": "JOHN",
        "middle_name": "CALVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Aide in Medford, OR
• Providers in Medford, OR by specialty
• Home Health Aide in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.