NPIMap

Organization Active NPI

Ear Nose and Throat Associates of Grants Pass PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Grants Pass, OR
National Provider Identifier
1366572158
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
MD10466 Issued in OR
Legal business name
EAR NOSE AND THROAT ASSOCIATES OF GRANTS PASS PC
Practice address
1600 NW 6TH St
South Suite
Grants Pass, OR 97526-1094
Phone
(541) 476-7775
Fax
(541) 476-3572
NPI assigned
Mar 7, 2007
Last updated
Apr 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Jeanne Reece
Title
Office Manager
Phone
(541) 476-7775

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD19356 OR
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X DO20532 OR
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD10466 OR Primary

Addresses

Primary practice location

1600 NW 6TH St
South Suite
Grants Pass, OR 97526-1094

Mailing address

1600 NW 6TH St
South Suite
Grants Pass, OR 97526-1094
Phone (541) 476-7775

Other identifiers 3

IdentifierTypeStateIssuer
150358MedicaidOR
232900MedicaidOR
073655MedicaidOR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1366572158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 NW 6TH ST",
            "address_2": "SOUTH SUITE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261094",
            "telephone_number": "541-476-7775",
            "fax_number": "541-476-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 NW 6TH ST",
            "address_2": "SOUTH SUITE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261094",
            "telephone_number": "541-476-7775",
            "fax_number": "541-476-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE AND THROAT ASSOCIATES OF GRANTS PASS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "REECE",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-476-7775"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OR",
            "license": "MD19356",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OR",
            "license": "DO20532",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OR",
            "license": "MD10466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150358",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232900",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073655",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.