Paul Daniel Fickes, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201805705NP-PP Issued in OR

Practice address

724 S Central Ave Ste 101
Medford, OR 97501-7808

Phone

(541) 789-4222

NPI assigned

Feb 15, 2018

Last updated

Aug 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2021 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Paradigm Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Medford, OR
  • NPI 1073147716
  NPD Authorized official

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1710487897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 S CENTRAL AVE STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017808",
            "telephone_number": "541-249-7244",
            "fax_number": "541-325-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S CENTRAL AVE STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017808",
            "telephone_number": "541-789-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICKES",
        "first_name": "PAUL",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-15",
        "last_updated": "2021-08-20",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201805705NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE BOARD OF NURSING",
            "identifier": "201805705NP-PP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Millicent Ferris
• Valerie Ferro
• Morgan D Ferros, MD
• Jeffrey E Feyerharm, RPH
• Dane M Fickes, PHARMD
• Shelly Myume Emi Fickes, LCSW
• Lynnette Regina Fields, MS
• Shannon Christine Fife, DO
• Silva Figueroa
• Matthew Filoon, FNP

• Psychiatric/Mental Health Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.