NPIMap

Organization Active NPI

Medford Womens Clinic LLP

  • Obstetrics & Gynecology Physician
  • Medford, OR
National Provider Identifier
1801829346
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MEDFORD WOMENS CLINIC LLP
Practice address
3170 State St
Medford, OR 97504-8450
Phone
(541) 864-8900
Fax
(541) 245-3315
NPI assigned
Jul 8, 2006
Reactivated
Dec 6, 2022
Last updated
Dec 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Mrs. Alisa Ann See
Title
Office Lead
Phone
(541) 864-8906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X OR Primary

Addresses

Primary practice location

3170 State St
Medford, OR 97504-8450

Mailing address

3170 State St
Medford, OR 97504-8450
Phone (541) 864-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419001001 OR Part B Supplier - Clinic/Group Practice 1254326259 Receives reassigned benefits from 10 practitioners
Practice locations: Medford, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0971513Medford Womens Clinic LLP3170 State Street, Medford, OR 97504Provider-performed microscopyMar 14, 2028

National Provider Directory

National Provider Directory

Locations

3170 State St
Medford, OR 97504
Phone (541) 734-3501

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1801829346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-864-8900",
            "fax_number": "541-245-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3170 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-864-8900",
            "fax_number": "541-245-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD WOMENS CLINIC LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "deactivation_date": "2022-11-10",
        "reactivation_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "SEE",
        "authorized_official_first_name": "ALISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE LEAD",
        "authorized_official_telephone_number": "541-864-8906",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.