Active NPI
Jere Sandefur, M.D.
- Radiation Oncology Physician
- Medford, OR
National Provider Identifier
1790744928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- MD16513
- Practice address
- 2825 E Barnett Rd
Medford, OR 97504-8332 - Phone
- (541) 789-4263
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | MD16513 | OR | Primary |
Addresses
Primary practice location
2825 E Barnett Rd
Medford, OR 97504-8332
Mailing address
PO Box 8509
Medford, OR 97501-5009
Phone (541) 772-0023
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD16513 | Other | OR | OREGON STATE LICENSE |
| 014279 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD16513 | OR | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1790744928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8509",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975015009",
"telephone_number": "541-772-0023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 E BARNETT RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048332",
"telephone_number": "541-789-4263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDEFUR",
"first_name": "JERE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "OR",
"license": "MD16513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON STATE LICENSE",
"identifier": "MD16513",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014279",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.