John G Mickelson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO226460 Issued in OR

Practice address

2930 NE West Devils Lake Rd Ste 3
Lincoln City, OR 97367-5195

Phone

(541) 557-6427

NPI assigned

Jul 18, 2006

Last updated

Sep 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ND, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Samaritan North Lincoln Hospital

  • Critical Access Hospital
  • Lincoln City, OR
  • NPI 1306897491
  Medicare reassignment NPD
• Samaritan Pacific Health Services, Inc

  dba Samaritan Pacific Communities Hospital

  • Critical Access Hospital
  • Newport, OR
  • NPI 1801847066
  Medicare reassignment NPD
• Samaritan Pacific Health Services, Inc.

  dba Samaritan Medical Group Occupational Medicine - Newport

  • Physical Medicine & Rehabilitation Physician
  • Newport, OR
  • NPI 1174888010
  Medicare reassignment NPD
• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment NPD
• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  Medicare reassignment NPD
• Samaritan North Lincoln Hospital

  dba Samaritan Kidney - Lincoln City

  • Nephrology Physician
  • Lincoln City, OR
  • NPI 1245599224
  NPD
• Samaritan North Lincoln Hospital

  dba Samaritan Pharmacy - Lincoln City

  • Community/Retail Pharmacy
  • Lincoln City, OR
  • NPI 1851509905
  NPD
• Samaritan Pacific Health Services, Inc

  dba Samaritan Kidney Specialists - Newport

  • Rural Health Clinic/Center
  • Depoe Bay, OR
  • NPI 1164781142
  NPD
• Samaritan Pacific Health Services, Inc.

  dba Samaritan Urology - Newport

  • Urology Physician
  • Newport, OR
  • NPI 1407325871
  NPD
• Innovis Health LLC

  dba Essentia Health-Osgood Clinic

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576

  Family Medicine

  NPD
• Innovis Health LLC

  dba Essentia Health West Acres Clinic

  • Family Medicine Physician
  • Fargo, ND
  • NPI 1437495264
  NPD
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1497773097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 NE WEST DEVILS LAKE RD STE 3",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973675195",
            "telephone_number": "541-557-6427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3838 12th Ave N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581022931",
            "country_code": "US",
            "telephone_number": "701-234-4700",
            "fax_number": "701-234-4757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "JOHN",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "34645",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "ND",
            "license": "6205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO226460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmickelson326801@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "2930 NE West Devils Lake Rd Ste 3",
            "city": "Lincoln City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973675195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey H McDonald, MD
• Kenneth Randall McEvers, DC
• Jacob Lane Merritt, MA
• Marty Michelson, LPC
• Dean W Mickelson, RPH
• Nicholas Miller, DPT
• Charito Apolonio Mina, P.T.
• Suji Moon, PHARMD
• Cheri Lynne Morgan, FNP-BC
• Judith Muller, RPH

• Family Medicine Physician in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.