Individual provider Active NPI

Denise A Ledbetter, PA

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1770538498
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01132 Issued in OR
Practice address
229 W Stewart Ave
Medford, OR 97501-3663
Phone
(541) 282-8808
Fax
(541) 618-6452
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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 PA01132 OR Primary

Addresses

Primary practice location

229 W Stewart Ave
Medford, OR 97501-3663

Mailing address

229 W Stewart Ave
Medford, OR 97501-3663
Phone (541) 828-8808

Other practice location 1

100 E. Main Street, Suite C
Medford, OR 97501
Phone (541) 789-4135

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060530000086 OR Practitioner - Physician Assistant 4082625363 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rogue Valley PhysiciansGroup PAC ID 1850374240, 22 clinicians

Practice addresses (Care Compare)

229 W Stewart Ave
Medford, OR 97501-3663
Phone (541) 282-8808

2900 Doctors Park Dr
Medford, OR 97504-4348
Phone (541) 282-2208

Hospital & facility affiliations

  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01132ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rogue Valley Physicians PC CurrentSince Jan 1, 2016 Accepting new patients
Asante CurrentSince Apr 17, 2006 Accepting new patients
Asante CurrentSince Apr 17, 2006 Accepting new patients
Rogue Valley Physicians Past Accepting new patients

Locations

615 S 2nd St
Central Point, OR 97502
Phone (541) 789-4004

229 W Stewart Ave
Medford, OR 97501
Phone (541) 282-8808

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

2900 Doctors Park Dr
Ste 250
Medford, OR 97504
Phone (541) 282-2208

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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 2

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1770538498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W STEWART AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013663",
            "telephone_number": "541-828-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W STEWART AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013663",
            "telephone_number": "541-282-8808",
            "fax_number": "541-618-6452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E. Main Street, Suite C",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "97501",
            "country_code": "US",
            "telephone_number": "541-789-4135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDBETTER",
        "first_name": "DENISE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.