Roxyann Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ROXYANN DERMATOLOGY, LLC

Practice address

3210 Hillcrest Park Dr Ste 100
Medford, OR 97504-7687

Phone

(541) 261-6412

NPI assigned

Jul 2, 2020

Last updated

Jul 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Liliana Rayburn

Title

Office Manager

Phone

(541) 261-6412

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeri Kersten Mendelson, M.D.

  • Specialist
  • Medford, OR
  • NPI 1134167182
  Medicare reassignment NPD

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1699392985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 HILLCREST RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049037",
            "telephone_number": "541-261-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 HILLCREST PARK DR STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047687",
            "telephone_number": "541-261-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROXYANN DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "RAYBURN",
        "authorized_official_first_name": "LILIANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-261-6412",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226802",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachelle Marie Roulier, P.A.
• Ian Rousseau, PT
• Wendy Jean Rowe, RN
• Elizabeth Anne Rowley, MN,FNP-C
• Roxy Ann Counseling LLC
• Cathie Roy, PT
• Daniel Matthew Roy, PHARMD
• Roylynn Underwood, Pmhnp, LLC (MindFlow Mental Health)
• RSL Medford, LLC (Farmington Square Medford)
• Summer Marie Ruberio

• Dermatology Physician in Medford, OR
• Providers in Medford, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.