Organization Active NPI

Ashland Family Practice LLC

  • Family Medicine Physician
  • Ashland, OR
National Provider Identifier
1740787456
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASHLAND FAMILY PRACTICE LLC
Practice address
935 Siskiyou Blvd
Ashland, OR 97520
Phone
(541) 482-2716
Fax
(541) 488-5461
NPI assigned
Apr 9, 2018
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Cynthia A Parks
Title
Provider
Phone
(541) 482-2716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

935 Siskiyou Blvd
Ashland, OR 97520

Mailing address

935 Siskiyou Blvd
Ashland, OR 97520-2143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180702001336 OR Part B Supplier - Clinic/Group Practice 6305192543 Receives reassigned benefits from 4 practitioners
Practice locations: Ashland, OR

National Provider Directory

National Provider Directory

Locations

935 Siskiyou Blvd
Ashland, OR 97520
Phone (541) 482-2716

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1740787456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 SISKIYOU BLVD",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 SISKIYOU BLVD",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "97520",
            "telephone_number": "541-482-2716",
            "fax_number": "541-488-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLAND FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "541-482-2716"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.