PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1093976243
Clinic/Center in Medford, OR

Q: What is Providence Health & Services - Oregon's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since June 20, 2008

1111 CRATER LAKE AVE, MEDFORD, OR 97504(541) 732-5250(541) 732-5251 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 29, 2025, Dec 27, 2021 (2 updates tracked since 2021).

On this page

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1093976243), doing business as Providence Medford Medical Center, is a healthcare organization registered as a clinic/center in Medford, Oregon and active in the NPI registry since June 2008. The organization lists Donald W Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1093976243

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address1111 CRATER LAKE AVEMedford, OR 97504-6241

Mailing AddressPo Box 31001-4199Pasadena, CA 91110-4199 · (541) 732-5250 · Fax (541) 732-5251

Phone(541) 732-5250

Fax(541) 732-5251

Organization SubpartYes

Authorized OfficialDonald W AndersonAssistant Secretary Of Enrollments · (425) 358-9786

Enumeration DateJune 20, 2008

Last NPPES UpdateMay 29, 20252 updates tracked since enumeration

NPPES CertifiedMay 29, 2025

✔ NPI 1093976243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

1111 CRATER LAKE AVE, Medford, OR 97504

Open in Google Maps ↗

Other Names 2

Doing Business AsProvidence Medford Medical Center

Doing Business AsProvidence Palliative Care South

Other Identifiers 1

Medicaid500617088OR

Accepted Insurance

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

Leave this field empty

Other Providers at the Same Location NPPES 20

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

PROVIDENCE HOSPITALISTS & INTENSIVISTS

Internal Medicine (Critical Care Medicine)