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RIVER ROCK FAMILY PRACTICE PC
NPI 1053957225
Nurse Practitioner - Family in Medford, OR

Active since November 22, 2019CLIA 38D2176821 · Waiver
3144 STATE ST, MEDFORD, OR 97504(541) 226-9840 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2023, Sep 12, 2022, Nov 22, 2019 (3 updates tracked since 2019).

About River Rock Family Practice Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIVER ROCK FAMILY PRACTICE PC (NPI 1053957225) is a healthcare organization registered as a family in Medford, Oregon and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through December 25, 2027 and lists Tammy Harrison, Secretary, as its authorized official.

NPPES Registry Identity

NPI1053957225
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameRIVER ROCK FAMILY PRACTICE PC
Location Address3144 STATE STMedford, OR 97504-8450
Mailing Address3144 State StMedford, OR 97504-8450 · (541) 226-9840
Phone(541) 226-9840
Organization SubpartYes
Authorized OfficialTammy HarrisonSecretary · (541) 226-9840
Enumeration DateNovember 22, 2019
Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2021
✔ NPI 1053957225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
3144 STATE ST, Medford, OR 97504
Open in Google Maps ↗

Other Identifiers 3

Other026845OR · Dmap
Other200550153NPOR · Fnpc
Other1356355846OR · Npi Individual

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2176821

River Rock Family Practice, PC · Medford, OR
Active · expires Dec 25, 2027
CLIA Number38D2176821
Laboratory TypePractitioner Other
Certificate Effective DateDecember 26, 2025
Certificate Expiration DateDecember 25, 2027
Laboratory DirectorMason C. Harrison
Laboratory Phone(541) 226-9840
Laboratory LocationRiver Rock Family Practice, PC3144 State Street, Medford, OR 97504
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINE MARIE GEHR MS- SLP
Speech-Language Pathologist
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 773-8255
THE SPEECH CENTER,INC.
Speech-Language Pathologist
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 773-8255
JENNIFER L BILLS M.A.,CCC-SLP
Speech-Language Pathologist
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 773-8255
JOCELYNN A ANDERSON M.S., CCC-SLP
Speech-Language Pathologist
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 773-8255
ROGUE ENDOCRINOLOGY AND METABOLIC CLINIC
Internal Medicine (Endocrinology, Diabetes & Metabolism)
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 772-9355
MARIE PASCALE SODERSTROM M.S.,SLP
Speech-Language Pathologist
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 773-8255
MR. MASON CLARKE HARRISON F.N.P.
Nurse Practitioner (Family)
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 226-9840
DR. LAURA JANE DELERUYELLE DNP
Nurse Practitioner (Family)
3144 STATE ST
MEDFORD, OR 97504
Jackson County (541) 773-9772

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is River Rock Family Practice PC's NPI number?

The NPI number for River Rock Family Practice PC is 1053957225. It was assigned to this organization in the NPPES registry on November 22, 2019.

Where is River Rock Family Practice PC located?

River Rock Family Practice PC is located at 3144 State St, Medford, OR 97504. The listed phone number is (541) 226-9840.

What is River Rock Family Practice PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does River Rock Family Practice PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2176821) is associated with this NPI, valid through December 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does River Rock Family Practice PC accept?

Health plans from Moda Health Plan, Inc. list River Rock Family Practice PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for River Rock Family Practice PC was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.