Pediatric TLC PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Legal business name

PEDIATRIC TLC PC

Practice address

1819 Nebraska Ave
Grants Pass, OR 97527-5701

Phone

(541) 479-2411

NPI assigned

Sep 14, 2021

Organization subpart

No

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

Authorized official

Name

Yvonne Martenia, FNP-BCNPI 1699246520

Title

Owner

Phone

(547) 479-2411

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• Direct secure messaging: yvonnemartenia@ptlcpc.allscriptsdirect.net

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yvonne Renee Martenia, FNP-BC

  • Family Nurse Practitioner
  • Grants Pass, OR
  • NPI 1699246520
  NPD Authorized official

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1548930464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275701",
            "telephone_number": "541-479-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275701",
            "telephone_number": "541-479-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC TLC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-14",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "MARTENIA",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "547-479-2411",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul V Anderson DDS LLC
• Joseph G Peaden, LMT
• Deanna Peck
• Heather Peck
• Leigh Anna Peden
• Galen W Pedrick
• Jeffrey Scott Pelson, O.D.
• Karissa Marie Pelson, D.P.T.
• Heather Nicole Pence
• Bo Peng, M.D., PH.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.