Southern Oregon Gynecology LLC

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

Legal business name

SOUTHERN OREGON GYNECOLOGY LLC

Practice address

2850 State St
Medford, OR 97504-8474

Phone

(541) 500-4747

Fax

(866) 267-6644

NPI assigned

Mar 21, 2025

Organization subpart

No

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

Authorized official

Name

Loretta Sandoval, NP, CNMNPI 1568762011

Title

Provider, Owner

Phone

(541) 500-4747

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Loretta Sandoval, RN, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Medford, OR
  • NPI 1568762011
  Medicare reassignment Care Compare group NPD Authorized official
• Kimberly D. Larson, WHCNP

  • Women's Health Nurse Practitioner
  • Medford, OR
  • NPI 1972545978
  Medicare reassignment Care Compare group NPD
• Kendall Lee Olson-Cassidy

  • Advanced Practice Midwife
  • Medford, OR
  • NPI 1902193527
  Medicare reassignment Care Compare group NPD
• Hillary Lynn Handelsman, CNM, WHNP, NP

  • Advanced Practice Midwife
  • Medford, OR
  • NPI 1215127519
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1861293284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048474",
            "telephone_number": "541-500-4747",
            "fax_number": "866-267-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048474",
            "telephone_number": "541-500-4747",
            "fax_number": "866-267-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OREGON GYNECOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "PROVIDER, OWNER",
        "authorized_official_telephone_number": "541-500-4747",
        "authorized_official_credential": "NP, CNM"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Obstetrics & Gynecology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.