Individual provider Active NPI

Ryan K. Wehmann, PA

  • Physician Assistant
  • Grants Pass, OR
National Provider Identifier
1720315104
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA190835 Issued in OR
Practice address
537 SW Union Ave., 2ND Floor
Grants Pass, OR 97527-5788
Phone
(541) 507-2050
Fax
(541) 507-2051
NPI assigned
Nov 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA190835 OR Primary

Addresses

Primary practice location

537 SW Union Ave., 2ND Floor
Grants Pass, OR 97527-5788

Mailing address

2825 E Barnett Rd
MSS
Medford, OR 97504-8332
Phone (541) 789-4207

Other identifiers 1

IdentifierTypeStateIssuer
500617933MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100312001033 WA Practitioner - Physician Assistant 8325173578 Reassigns benefits to 1 organization
I20190130001092 OR Practitioner - Physician Assistant 8325173578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

537 SW Union Ave
2ND FL Suite 2C
Grants Pass, OR 97527-5543
Phone (541) 507-2110

537 Union Ave
FL 2
Grants Pass, OR 97527-5543
Phone (541) 507-2150

625 SW Ramsey Ave
Suite a
Grants Pass, OR 97527-5808
Phone (541) 507-2290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA190835ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Orthopedics Inc Physician Assistant CurrentSince Sep 1, 2022 Accepting new patients
Peacehealth CurrentSince Jan 10, 2010 Accepting new patients

Locations

702 SW Ramsey Ave
Ste 112
Grants Pass, OR 97527
Phone (541) 472-0603

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

2780 E Barnett Rd
Ste 200
Medford, OR 97504
Phone (541) 779-6250

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Organizations & group practices 3

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 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": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1720315104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "address_2": "MSS",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-4207",
            "fax_number": "541-789-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 SW UNION AVE., 2ND FLOOR",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275788",
            "telephone_number": "541-507-2050",
            "fax_number": "541-507-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHMANN",
        "first_name": "RYAN",
        "middle_name": "K.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-05",
        "last_updated": "2024-02-21",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA190835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500617933",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.