Active NPI
John G Stanko, PA-C
- Physician Assistant
- Grants Pass, OR
National Provider Identifier
1558549709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 702 SW Ramsey Ave Ste 112
Grants Pass, OR 97527-5859 - Phone
- (541) 472-0603
- Fax
- (541) 472-0609
- NPI assigned
- Feb 8, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | |||
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
702 SW Ramsey Ave Ste 112
Grants Pass, OR 97527-5859
Mailing address
702 SW Ramsey Ave Ste 112
Grants Pass, OR 97527-5859
Phone (541) 472-0603
Other practice location 1
107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500630894 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1558549709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 SW RAMSEY AVE STE 112",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275859",
"telephone_number": "541-472-0603",
"fax_number": "541-472-0609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 SW RAMSEY AVE STE 112",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275859",
"telephone_number": "541-472-0603",
"fax_number": "541-472-0609"
}
],
"practiceLocations": [
{
"address_1": "107 Dilworth St",
"address_purpose": "LOCATION",
"city": "Glendive",
"state": "MT",
"postal_code": "593302053",
"country_code": "US",
"telephone_number": "406-345-8925",
"fax_number": "406-345-8908",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STANKO",
"first_name": "JOHN",
"middle_name": "G",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-08",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500630894",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.