NPIMap

Organization Active NPI

Cascade Family Practice, LLC

  • Clinic/Center
  • Medford, OR
National Provider Identifier
1538667662
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CASCADE FAMILY PRACTICE, LLC
Practice address
21 Hawthorne St
Medford, OR 97504-7113
Phone
(541) 203-7558
Fax
(541) 690-1234
NPI assigned
Jan 23, 2018
Last updated
Jan 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Mrs. Deborah Boles, FNP
Title
Owner
Phone
(541) 840-3633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

21 Hawthorne St
Medford, OR 97504-7113

Mailing address

21 Hawthorne St
Medford, OR 97504-7113
Phone (541) 203-7558

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1538667662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HAWTHORNE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047113",
            "telephone_number": "541-203-7558",
            "fax_number": "541-690-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HAWTHORNE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047113",
            "telephone_number": "541-203-7558",
            "fax_number": "541-690-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "BOLES",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-840-3633",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.