Kelly Fruth

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA214041 Issued in OR

Practice address

520 SW Ramsey Ave
Grants Pass, OR 97527-5535

Phone

(541) 472-7810

Fax

(541) 472-7811

NPI assigned

May 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
• Riverside Home Health Care Home health agency, Grants Pass, OR, CCN 387143
• Accentcare Home Health of Rogue Valley, LLC Home health agency, Medford, OR, CCN 387098
• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Accentcare Home Health of Rogue Valley, LLC

  • Home Health Agency
  • Medford, OR
  • NPI 1912228727
  Care Compare affiliation
• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation
• Rogue River Healthcare LLC

  • Home Health Agency
  • Grants Pass, OR
  • NPI 1841805223
  Care Compare affiliation
• Three Rivers Homecare, LLC

  • Home Health Agency
  • Grants Pass, OR
  • NPI 1396977393
  Care Compare affiliation

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1730701285",
    "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": "520 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275535",
            "telephone_number": "541-472-7810",
            "fax_number": "541-472-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUTH",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57800",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA214041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahnee Rae Freitas, L.M.T
• Tawnya Freudenthaler
• Timothy Kyle Friend
• Monika Froehlich, D.P.M.
• Megan M Frost, MD
• Gina Fry
• June Fryer, RPH
• Gary Fuller, R.PH.
• Matthew David Fullmer, DO
• Julia Aenes Funaro, LMT

• Physician Assistant in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.
• 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.