Organization Active NPI

Mederi Foundation

  • Clinic/Center
  • Ashland, OR
National Provider Identifier
1972058329
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
BL-004682 Issued in OR
Legal business name
MEDERI FOUNDATION
Doing business as
Mederi Center
Practice address
478 Russell St Ste 101
Ashland, OR 97520-7337
Phone
(541) 488-3133
Fax
(541) 488-6949
NPI assigned
Aug 15, 2016
Organization subpart
Yes
Parent organization
MEDERI FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Authorized official

Name
Jennifer Ann Yance
Title
Executive Director
Phone
(541) 488-0210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X BL-004682 OR Primary

Addresses

Primary practice location

478 Russell St Ste 101
Ashland, OR 97520-7337

Mailing address

478 Russell St Ste 101
Ashland, OR 97520-7337
Phone (541) 488-0210

Other names 1

  • Mederi Center Doing business as

National Provider Directory

National Provider Directory
Part of
Mederi Foundation

Locations

180 Clear Creek Dr
Ashland, OR 97520

478 Russell St
Ste 101
Ashland, OR 97520
Phone (541) 488-3133

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1972058329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 RUSSELL ST STE 101",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975207337",
            "telephone_number": "541-488-0210",
            "fax_number": "541-488-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 RUSSELL ST STE 101",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975207337",
            "telephone_number": "541-488-3133",
            "fax_number": "541-488-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDERI FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDERI FOUNDATION",
        "enumeration_date": "2016-08-15",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "YANCE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-488-0210"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "BL-004682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mederi Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.