Individual provider Active NPI

Uzomechine Thabiso Chiedozi, MD

  • Family Medicine Physician
  • Medford, OR
National Provider Identifier
1699160903
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD190081 Issued in OR
Practice address
70 Bower Dr
Medford, OR 97501-3689
Phone
(541) 734-3430
Fax
(541) 734-3638
NPI assigned
Apr 2, 2015
Last updated
Feb 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD190081 OR Primary

Addresses

Primary practice location

70 Bower Dr
Medford, OR 97501-3689

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (541) 734-3430

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address uchiedozi991353@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180906002824 OK Practitioner - Emergency Medicine 1759680721 Reassigns benefits to 2 organizations
I20190212001243 OR Practitioner - Family Practice 1759680721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

70 Bower Dr
Medford, OR 97501-3689
Phone (541) 732-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27111MNMDClinical Social Worker
MD190081ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Emergency Services of Oklahoma PC CurrentSince Aug 1, 2018 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2019 Accepting new patients
South Central Emergency Services PC CurrentSince Aug 1, 2018 Accepting new patients
Providence Health & Services Oregon Family Medicine Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2019 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

70 Bower Dr
Medford, OR 97501
Phone (541) 732-8360

870 S Front St
Ste 200
Medford, OR 97502
Phone (541) 664-3346

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

Interoperability endpoints

  • Direct secure messaging: uchiedozi991353@oc.providencedirect.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1699160903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "541-734-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BOWER DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013689",
            "telephone_number": "541-734-3430",
            "fax_number": "541-734-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIEDOZI",
        "first_name": "UZOMECHINE",
        "middle_name": "THABISO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD190081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "uchiedozi991353@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "70 Bower Dr",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975013689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.