Individual provider Active NPI

Patricia L Mecum, FNP

  • Family Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1841293180
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Practice address
702 Ramsey Ave
Ste 112
Grants Pass, OR 97527-5572
Phone
(541) 472-0603
Fax
(541) 472-0609
NPI assigned
May 31, 2005
Last updated
Jan 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X OR Primary

Addresses

Primary practice location

702 Ramsey Ave
Ste 112
Grants Pass, OR 97527-5572

Mailing address

702 Ramsey Ave
Ste 112
Grants Pass, OR 97527-5572
Phone (541) 472-0603

Other identifiers 2

IdentifierTypeStateIssuer
P00268292OtherORMEDICARE RAILROAD
275474MedicaidOR

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
I20200814001968 OR Order and Referring Only - Nurse Practitioner 8224063755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200450112 NP FNP PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Orthopedic Center, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1841293180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 RAMSEY AVE",
            "address_2": "STE 112",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275572",
            "telephone_number": "541-472-0603",
            "fax_number": "541-472-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 RAMSEY AVE",
            "address_2": "STE 112",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275572",
            "telephone_number": "541-472-0603",
            "fax_number": "541-472-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECUM",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00268292",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275474",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.