Lindy Sue Deatherage, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD28956 Issued in OR

Practice address

842 E Main St
Anesthesia Assoc of Medford, PC
Medford, OR 97504-7134

Phone

(541) 773-7273

Fax

(541) 773-2027

NPI assigned

Apr 19, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Anesthesia Associates of Medford PC

  • Anesthesiology Physician
  • Medford, OR
  • NPI 1073543963
  NPD
• Asante

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  NPD
• Active Health Chiropractic, PC

  • Chiropractor
  • Central Point, OR
  • NPI 1780989889
  NPD (past)

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

{
    "created_epoch": "1208563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1508030651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "address_2": "ANESTHESIA ASSOC OF MEDFORD, PC",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010132",
            "telephone_number": "541-773-7273",
            "fax_number": "541-773-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 E MAIN ST",
            "address_2": "ANESTHESIA ASSOC OF MEDFORD, PC",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047134",
            "telephone_number": "541-773-7273",
            "fax_number": "541-773-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEATHERAGE",
        "first_name": "LINDY",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-19",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "63518691205",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD28956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500606314",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan De Valle
• Derek John De Vry
• Tracy Lynn Deal, LMT
• Mia N Deane, LMT
• Yin Deascentis
• Giovanna A Debortoli
• Angela Marie Dedionisio, O.D.
• Shawnna Dedrick
• Andrew Scott Defrance, QMHP - NOT LICENSED
• Kyla Defranco, COTA/L

• Anesthesiology Physician in Medford, OR
• Providers in Medford, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.