Individual provider Active NPI

Audrey Peterson, PA

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1821859745
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
691 Murphy Rd Ste 107
Medford, OR 97504-4311
Phone
(541) 789-5121
NPI assigned
Jan 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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 Primary

Addresses

Primary practice location

691 Murphy Rd Ste 107
Medford, OR 97504-4311

Mailing address

2825 E Barnett Rd # MSS
Medford, OR 97504-8332
Phone (785) 313-5209

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
I20240325003112 OR Practitioner - Physician Assistant 7618314790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
AsanteGroup PAC ID 0547177321, 141 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Three Rivers Medical Center, LLC CurrentSince Nov 17, 2025 Accepting new patients
Asante CurrentSince Aug 4, 2025 Accepting new patients
Asante CurrentSince Aug 4, 2025 Accepting new patients
Asante Past Accepting new patients

Locations

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

Organizations & group practices 4

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 6

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": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1821859745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD # MSS",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "785-313-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 MURPHY RD STE 107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044311",
            "telephone_number": "541-789-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "AUDREY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.