Individual provider Active NPI

Cynthia Ann Parks-Landis, FNP

  • Family Nurse Practitioner
  • Ashland, OR
National Provider Identifier
1457624280
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201250023NP Issued in OR
Practice address
935 Siskiyou Blvd
Ashland, OR 97520-2143
Phone
(541) 482-2716
Fax
(541) 488-5461
NPI assigned
Feb 9, 2012
Last updated
Dec 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201250023NP OR Primary

Addresses

Primary practice location

935 Siskiyou Blvd
Ashland, OR 97520-2143

Mailing address

935 Siskiyou Blvd
Ashland, OR 97520-2143
Phone (541) 482-2716

Other identifiers 1

IdentifierTypeStateIssuer
500643191MedicaidOR

Other names 1

  • Cynthia Ann Parks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000083 OR Practitioner - Nurse Practitioner 4688834211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ashland Family Practice LLCGroup PAC ID 6305192543, 4 clinicians

Practice addresses (Care Compare)

935 Siskiyou Blvd
Ashland, OR 97520-2143
Phone (541) 488-4216

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Family Practice LLC CurrentSince Jul 1, 2018 Accepting new patients
Ashland Family Practice PastSince Mar 9, 2012 Accepting new patients

Locations

935 Siskiyou Blvd
Ashland, OR 97520
Phone (541) 482-2716

Interoperability endpoints

  • Direct secure messaging: cindy.parks-landis.1@24414.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24414/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1457624280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 SISKIYOU BLVD",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202143",
            "telephone_number": "541-482-2716",
            "fax_number": "541-488-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 SISKIYOU BLVD",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202143",
            "telephone_number": "541-482-2716",
            "fax_number": "541-488-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS-LANDIS",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201250023NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500643191",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "PARKS",
            "middle_name": "ANN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.