NPIMap

Organization Active NPI

Southern Oregon Spine Care, P.C.

  • Orthopaedic Surgery of the Spine Physician
  • Medford, OR
National Provider Identifier
1912349580
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
MD18861 Issued in OR
Legal business name
SOUTHERN OREGON SPINE CARE, P.C.
Practice address
1311 Barnett Road Ste 201
Medford, OR 97504
Phone
(541) 770-5007
NPI assigned
Jul 24, 2013
Last updated
Sep 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Mark Peterson, MDNPI 1699763607
Title
Doctor
Phone
(541) 770-5007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X MD18861 OR Primary

Addresses

Primary practice location

1311 Barnett Road Ste 201
Medford, OR 97504

Mailing address

1311 Barnett Road Ste 201
Medford, OR 97504

National Provider Directory

National Provider Directory

Locations

1311 E Barnett Rd
Ste 201
Medford, OR 97504
Phone (541) 770-5007

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1912349580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 BARNETT ROAD STE 201",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 BARNETT ROAD STE 201",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-770-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OREGON SPINE CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "541-770-5007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OR",
            "license": "MD18861",
            "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 Sep 17, 2013; 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.