Individual provider Active NPI

Savana Marisa Brown, PA-C

  • Surgical Physician Assistant
  • Medford, OR
National Provider Identifier
1659884401
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA190601 Issued in OR
Practice address
520 Medical Center Dr Ste 300
Medford, OR 97504-4316
Phone
(541) 930-8907
Fax
(541) 245-4820
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA190601 OR Primary

Addresses

Primary practice location

520 Medical Center Dr Ste 300
Medford, OR 97504-4316

Mailing address

520 Medical Center Dr Ste 300
Medford, OR 97504-4316
Phone (541) 930-8907

Other identifiers 1

IdentifierTypeStateIssuer
500758357MedicaidOR

Other names 1

  • Savana Marisa Cochrane Former name

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
I20190402001936 OR Practitioner - Physician Assistant 3779824677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Surgical Specialists PCGroup PAC ID 4789589540, 21 clinicians

Practice addresses (Care Compare)

520 Medical Ctr Dr
Suite 300
Medford, OR 97504-4316
Phone (541) 930-8907

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA190601ORMDSurgical Physician Assistant

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 3

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": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1659884401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR STE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044316",
            "telephone_number": "541-930-8907",
            "fax_number": "541-245-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR STE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044316",
            "telephone_number": "541-930-8907",
            "fax_number": "541-245-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SAVANA",
        "middle_name": "MARISA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA190601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500758357",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAVANA",
            "last_name": "COCHRANE",
            "middle_name": "MARISA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.