Allen Lewis Hayter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01199 Issued in OR

Practice address

1600 Delta Waters Rd
Suite 107
Medford, OR 97504-9114

Phone

(541) 858-2515

Fax

(541) 858-2514

NPI assigned

Feb 28, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Immediate Care, LLCGroup PAC ID 7618876723, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Medford, OR
  • NPI 1982709226
  Medicare reassignment Care Compare group
• Valley Immediate Care, LLC

  • Non-Pharmacy Dispensing Site
  • Ashland, OR
  • NPI 1275049546
  NPD (past)
• Valley Immediate Care, LLC

  • Non-Pharmacy Dispensing Site
  • Grants Pass, OR
  • NPI 1821504192
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982731618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N CENTRAL AVE",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015873",
            "telephone_number": "541-734-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DELTA WATERS RD",
            "address_2": "SUITE 107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049114",
            "telephone_number": "541-858-2515",
            "fax_number": "541-858-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYTER",
        "first_name": "ALLEN",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01199",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01199",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA01199",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayden Family Dentistry Group
• Heather Lee Hayes, FNP-C
• Johanna Hayes
• Kaleef X a Hayes
• William Brendon Haynal, MD
• Heather Leigh Headley, RN
• Janessa Kylene Headley, QMHA
• Healing Hands PT and Wellness
• Health Alliance of Southern Oregon LLC
• Healthy Living at Home - Medford LLC

• Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.