Living Waters Family Practice

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200250078NP Issued in OR

Legal business name

LIVING WATERS FAMILY PRACTICE

Practice address

181 NW Bunnell Ave
Grants Pass, OR 97526-6012

Phone

(541) 474-9400

Fax

(541) 474-2232

NPI assigned

May 27, 2011

Last updated

May 27, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia Mahoney, FNPNPI 1174571186

Title

Owner

Phone

(541) 474-9400

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cynthia Marie Mahoney, FNP

  • Adult Health Nurse Practitioner
  • Grants Pass, OR
  • NPI 1174571186
  Authorized official Same address or phone

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1457644155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 NW BUNNELL AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975266012",
            "telephone_number": "541-474-9400",
            "fax_number": "541-474-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 NW BUNNELL AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975266012",
            "telephone_number": "541-474-9400",
            "fax_number": "541-474-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-474-9400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200250078NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Michelle Callahan (Grants Pass Pediatrics)
• Sandra Sue Lister, LMT
• Joanne E Little
• Melissa Renee Litwiller, A.R.N.P.
• Lois M Livengood, L.M.T.
• Randel Livingood
• Ashley Livingston
• Ellen W. Loan, PT
• Laila Lobo, M.D.
• Lisa A Locke, B.S.

• Family Nurse Practitioner in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.