NPIMap

Organization Active NPI

Cascade West Medical Practice LLC

  • Adult Health Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1639468432
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
200850056NP Issued in OR
Legal business name
CASCADE WEST MEDICAL PRACTICE LLC
Practice address
201 NE Savage St
Grants Pass, OR 97526-1309
Phone
(541) 787-4360
Fax
(360) 216-7677
NPI assigned
Apr 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Authorized official

Name
Mr. Michael L Johnson
Title
Office Manager
Phone
(541) 450-8345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X 200850056NP OR Primary

Addresses

Primary practice location

201 NE Savage St
Grants Pass, OR 97526-1309

Mailing address

PO Box 738
Merlin, OR 97532-0738
Phone (541) 787-4360

Other names 1

  • Cascade West Primary Care Clinic Doing business as

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: leonaanderson@cwpcc.allscriptsdirect.net
  • Direct secure messaging: lindapickerjohnson@cwpcc.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1639468432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 738",
            "city": "MERLIN",
            "state": "OR",
            "postal_code": "975320738",
            "telephone_number": "541-787-4360",
            "fax_number": "360-216-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NE SAVAGE ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261309",
            "telephone_number": "541-787-4360",
            "fax_number": "360-216-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE WEST MEDICAL PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-450-8345",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200850056NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade West Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 1, 2011; 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.