Degrazia Wellness, LLC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

201500652NP-PP Issued in OR

Legal business name

DEGRAZIA WELLNESS, LLC

Practice address

3210 Hillcrest Park Dr
Suite 100
Medford, OR 97504-7693

Phone

(541) 494-8888

Fax

(541) 494-1300

NPI assigned

Apr 12, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Karissa Stults

Title

Business Manager

Phone

(541) 890-5217

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1780048124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 HILLCREST PARK DR",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047693",
            "telephone_number": "541-494-8888",
            "fax_number": "541-494-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 HILLCREST PARK DR",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047693",
            "telephone_number": "541-494-8888",
            "fax_number": "541-494-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEGRAZIA WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "STULTS",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "541-890-5217",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "201500652NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanna A Debortoli
• Angela Marie Dedionisio, O.D.
• Shawnna Dedrick
• Andrew Scott Defrance, QMHP - NOT LICENSED
• Kyla Defranco, COTA/L
• Christa Elane Degrazia, NP
• Tova Dejack, MSW, LCSW
• Bradley Dekorte, D.O.
• Michael Andrew Dekorte, DPM
• Michele Dekorte, MD

• All providers in Medford, OR
• Women's Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.