Rogue Integrative Care, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

200950142NP Issued in OR

Legal business name

ROGUE INTEGRATIVE CARE, LLC

Practice address

2612 E Barnett Rd
Medford, OR 97504-8344

Phone

(541) 773-3191

Fax

(541) 779-5647

NPI assigned

Nov 3, 2009

Last updated

Nov 3, 2009By 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

Justin E Henderson, ANP-C

Title

Direrctor

Phone

(541) 646-1760

Specialties & licenses 1

Addresses

Locations

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.

• Renee Edwards, FNP

  • Family Nurse Practitioner
  • Corvallis, OR
  • NPI 1346241262
  NPD (past)

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

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1700113313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 DARK HOLLOW RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014316",
            "telephone_number": "541-646-1760",
            "fax_number": "541-779-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048344",
            "telephone_number": "541-773-3191",
            "fax_number": "541-779-5647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE INTEGRATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-03",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRERCTOR",
        "authorized_official_telephone_number": "541-646-1760",
        "authorized_official_credential": "ANP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "200950142NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rogue Community Health
• Rogue Endocrinology and Metabolic Clinic
• Rogue Functional Wellness LLC
• Rogue Health LLC
• Rogue Holistic Therapy
• Rogue Massage Clinic, LLC
• Rogue Pediatric Therapies, LLC (ABN of More Than Words Speech Therapy, LLC)
• Rogue Periodontics & Implant Dentistry
• Rogue Reflection Counseling
• Rogue Retreat

• Primary Care Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; 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.