PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1316024128
Psychiatry & Neurology - Child & Adolescent Psychiatry in Medford, OR

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

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Active since November 01, 2006

840 ROYAL AVE, SUITE 110, MEDFORD, OR 97504(541) 732-8370(541) 732-8371 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 19, 2025, May 12, 2025, Jun 15, 2021 and 1 more (4 updates tracked since 2020).

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 1316024128), doing business as Pmg South Medford Pediatrics, is a healthcare organization registered as a child & adolescent psychiatry in Medford, Oregon and active in the NPI registry since November 2006. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1316024128

Entity TypeOrganization

Primary Taxonomy2084P0804X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address840 ROYAL AVE, SUITE 110Medford, OR 97504-6461

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494

Phone(541) 732-8370

Fax(541) 732-8371

Organization SubpartYes

Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786

Enumeration DateNovember 1, 2006

Last NPPES UpdateNovember 19, 20254 updates tracked since enumeration

NPPES CertifiedNovember 19, 2025

✔ NPI 1316024128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedClinic/CenterTaxonomy 261Q00000X

Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X

840 ROYAL AVE, Medford, OR 97504

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Other Names 2

Doing Business AsPmg South Medford Pediatrics

Doing Business AsProvidence Medical Group South

Other Identifiers 1

OtherCG6801OR · Rail Road Medicare

Accepted Insurance

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

Medical Equipment Supplier Medicare DMEPOS 5

Medicare supplier enrollment and the product categories Providence Health & Services - Oreg carries, from the Medicare DMEPOS supplier directory.

Providence Health & Services - Oreg

DMEPOS supplier · Medford, OROperated by Providence Health & Services Oregon

✔

Accepts Medicare assignment

Providence Health & Services - Oreg agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20483501

Medicare Participant SinceMay 11, 2015

Supplier Location840 Royal Ave Ste 120Medford, OR 97504

Phone(541) 732-5566

Supplier Specialties

Medical Supply Company Other

Medicare Product Categories

External Infusion Pumps and/or Supplies

An infusion pump is necessary to safely administer the drug

Implanted Infusion Pumps and/or Supplies

Implantable infusion pumps, catheters, refill kits

Enteral Nutrients

Enteral formula

Enteral Equipment and/or Supplies

Enteral infusion pumps, enteral nutrition supply kits

Parenteral Equipment and/or Supplies

Parenteral infusion pumps, parenteral nutrition supply kits

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 5

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

DR. CURTIS T ODDO MD

Pediatrics

840 ROYAL AVE, SUITE 110
MEDFORD, OR 97504

Jackson County (541) 732-8370

PROVIDENCE HEALTH & SERVICES OREGON

Durable Medical Equipment & Medical Supplies

840 ROYAL AVE, SUITE 120
MEDFORD, OR 97504

Jackson County (541) 732-5566

DR. MICHAEL A DAVIS M.D

Pediatrics

840 ROYAL AVE, SUITE 110
MEDFORD, OR 97504

Jackson County (541) 732-8370

WHITNEY A SERAFINI PNP

Nurse Practitioner (Pediatrics)

840 ROYAL AVE, STE 110
MEDFORD, OR 97504

Jackson County (541) 732-8360

DR. AMY J MUNRO D.O.

Pediatrics

840 ROYAL AVE, SUITE 110
MEDFORD, OR 97504

Jackson County (541) 732-8370

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 Providence Health & Services - Oregon's NPI number?

The NPI number for Providence Health & Services - Oregon is 1316024128. It was assigned to this organization in the NPPES registry on November 1, 2006. The provider is doing business as Pmg South Medford Pediatrics and Providence Medical Group South.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 840 Royal Ave Suite 110, Medford, OR 97504. The listed phone number is (541) 732-8370.

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

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Does Providence Health & Services - Oregon accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Providence Health & Services - Oreg accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Providence Health & Services - Oregon accept?

Health plans from Providence Health Plan list Providence Health & Services - Oregon 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 Providence Health & Services - Oregon was last updated on November 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.