Molly Grace Emberlin, PAC, M.S.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01100 Issued in OR

Practice address

55 Coburg Rd
Slocum Orthopedics PC
Eugene, OR 97401-2433

Phone

(541) 485-8111

Fax

(541) 868-0883

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Molly Petty Former name

Medicare fee-for-service enrollment

Enrolled in OR

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

Practice roles

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.

• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment
• Icco, LLC

  • Rural Health Clinic/Center
  • Junction City, OR
  • NPI 1649886441
  NPD
• Slocum Orthopedics, PC

  • Orthopaedic Surgery Physician
  • Eugene, OR
  • NPI 1881694867
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1619048469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "address_2": "SLOCUM ORTHOPEDICS PC",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433",
            "telephone_number": "541-485-8111",
            "fax_number": "541-868-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "address_2": "SLOCUM ORTHOPEDICS PC",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433",
            "telephone_number": "541-485-8111",
            "fax_number": "541-868-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBERLIN",
        "first_name": "MOLLY",
        "middle_name": "GRACE",
        "credential": "PAC, M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "PETTY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elrod Center
• Kenneth J. Elsbree
• Rian E Elschlager, LMT
• Keira Bryn Elsis, LMT; CA
• Lilly Grace Elston
• Julie M Embree, PT
• Mallory Embrey
• Orion Emelio
• Emerald Acupuncture Center
• Emerald Behavioral Health LLC

• Physician Assistant in Eugene, OR
• Providers in Eugene, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.