Individual provider Active NPI

Kathryn Ann Keller

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1619667698
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2780 E Barnett Rd Ste 200
Medford, OR 97504-8674
Phone
(541) 779-6250
NPI assigned
May 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2780 E Barnett Rd Ste 200
Medford, OR 97504-8674

Mailing address

2780 E Barnett Rd Ste 200
Medford, OR 97504-8674
Phone (541) 779-6250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110000848 OR Practitioner - Physician Assistant 8527596147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Oregon Orthopedics IncGroup PAC ID 1456256528, 64 clinicians

Practice addresses (Care Compare)

2780 E Barnett Rd
Suite 200
Medford, OR 97504-8674
Phone (541) 779-6250

Hospital & facility affiliations

  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Curry General Hospital Hospital, Gold Beach, OR, CCN 381322
  • Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Orthopedics Inc Physician Assistant CurrentSince Feb 1, 2025 Accepting new patients

Locations

1780 Nebraska Ave
Grants Pass, OR 97527
Phone (541) 472-0603

2780 E Barnett Rd
Ste 200
Medford, OR 97504
Phone (541) 779-6250

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1619667698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.