NPIMap

Organization Active NPI

Mark Allen Rondeau

  • Family Medicine Physician
  • Grants Pass, OR
National Provider Identifier
1861674780
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22314 Issued in OR
Legal business name
MARK ALLEN RONDEAU
Practice address
124 NW Midland Ave
Ste J
Grants Pass, OR 97526-1269
Phone
(541) 476-8859
Fax
(541) 955-8611
NPI assigned
Dec 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Melony Dechenne
Title
Bookkeeper
Phone
(541) 476-8859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 22314 OR Primary

Addresses

Primary practice location

124 NW Midland Ave
Ste J
Grants Pass, OR 97526-1269

Mailing address

124 NW Midland Ave
Ste J
Grants Pass, OR 97526-1269
Phone (541) 476-8859

Other identifiers 1

IdentifierTypeStateIssuer
288514MedicaidOR

National Provider Directory

National Provider Directory

Locations

124 NW Midland Ave
Ste 109
Grants Pass, OR 97526
Phone (541) 476-8859

124 NW Midland Ave
Ste J
Grants Pass, OR 97526
Phone (541) 476-8859

Practitioners & affiliated clinicians

Practitioners 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1861674780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NW MIDLAND AVE",
            "address_2": "STE J",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261269",
            "telephone_number": "541-476-8859",
            "fax_number": "541-955-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NW MIDLAND AVE",
            "address_2": "STE J",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261269",
            "telephone_number": "541-476-8859",
            "fax_number": "541-955-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK ALLEN RONDEAU",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "DECHENNE",
        "authorized_official_first_name": "MELONY",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "541-476-8859"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "22314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288514",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.