Organization Active NPI

Advanced Care Life Centers

  • Primary Care Clinic/Center
  • Medford, OR
National Provider Identifier
1982432571
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ADVANCED CARE LIFE CENTERS
Practice address
1463 E McAndrews Rd # a
Medford, OR 97504-6107
Phone
(541) 262-2252
Fax
(541) 787-6382
NPI assigned
Jul 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Michelle Eileen Macgregor, RN
Title
Owner
Phone
(541) 707-2257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1463 E McAndrews Rd # a
Medford, OR 97504-6107

Mailing address

1463 E McAndrews Rd # a
Medford, OR 97504-6107
Phone (541) 262-2252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240905000929 OR Part B Supplier - Clinic/Group Practice 5799225702 Receives reassigned benefits from 4 practitioners
Practice locations: Medford, OR

National Provider Directory

National Provider Directory

Locations

1463 E McAndrews Rd
#A
Medford, OR 97504
Phone (541) 252-2262

1463 E McAndrews Rd
Ste A
Medford, OR 97504

Practitioners & affiliated clinicians

Practitioners 4

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": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1982432571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 E MCANDREWS RD # A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046107",
            "telephone_number": "541-262-2252",
            "fax_number": "541-787-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 E MCANDREWS RD # A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046107",
            "telephone_number": "541-262-2252",
            "fax_number": "541-787-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE LIFE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "MACGREGOR",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-707-2257",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "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 Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.