1. Home
  2. Directory
  3. Oregon
  4. Jacksonville
  5. Nurse Practitioner
  6. NPI Profile

AUTUMN D MERCER AGNP-C LLC
NPI 1790241065
Nurse Practitioner - Adult Health in Jacksonville, OR

Active since February 12, 2019CLIA 38D2299707 · Waiver
620 N 5TH ST, JACKSONVILLE, OR 97530(503) 309-8026(541) 291-9819 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 24, 2023, Feb 22, 2022, Feb 12, 2019 (3 updates tracked since 2019).

About Autumn D Mercer Agnp-c Llc NPPES

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

AUTUMN D MERCER AGNP-C LLC (NPI 1790241065) is a healthcare organization registered as an adult health in Jacksonville, Oregon and active in the NPI registry since February 2019. The organization holds a CLIA Waiver certificate valid through February 25, 2028 and lists Autumn Dawn Mercer, Provider, as its authorized official.

NPPES Registry Identity

NPI1790241065
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameAUTUMN D MERCER AGNP-C LLC
Location Address620 N 5TH STJacksonville, OR 97530-9659
Mailing Address620 N 5th StJacksonville, OR 97530-9659 · (503) 309-8026 · Fax (541) 291-9819
Phone(503) 309-8026
Fax(541) 291-9819
Organization SubpartNo
Authorized OfficialAutumn Dawn MercerProvider · (503) 309-8026
Enumeration DateFebruary 12, 2019
Last NPPES UpdateOctober 24, 20233 updates tracked since enumeration
NPPES CertifiedOctober 24, 2023
✔ NPI 1790241065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
620 N 5TH ST, Jacksonville, OR 97530
Open in Google Maps ↗

Other Identifiers 1

Medicaid500733407OR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Autumn D Mercer Agnp-c Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Autumn D Mercer Agnp-C LLC, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Babbette Murphy, NP
Nurse Practitioner
NPI 1407294853
620 N 5TH ST
Jacksonville, OR 97530
(458) 220-7597
✔ PECOS✔ Accepts Medicare0.6 mi
Autumn Mercer, FNP
Nurse Practitioner
NPI 1669981148
825 BENNETT AVE
Medford, OR 97504
(541) 779-5228
✔ PECOS✔ Accepts Medicare5.2 mi
Susan Rugh, NP-C
Nurse Practitioner
NPI 1659770576
825 BENNETT AVE
Medford, OR 97504
(541) 608-1996
✔ PECOS✔ Accepts Medicare5.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 38D2299707

Autumn D Mercer, Agnp-C, LLC · Jacksonville, OR
Active · expires Feb 25, 2028
CLIA Number38D2299707
Laboratory TypePractitioner Other
Certificate Effective DateFebruary 26, 2026
Certificate Expiration DateFebruary 25, 2028
Laboratory DirectorAutumn D. Mercer
Laboratory Phone(458) 220-7597
Laboratory LocationAutumn D Mercer, Agnp-C, LLC620 N 5th Street, Jacksonville, OR 97530
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Autumn D Mercer Agnp-C LLC's NPI number?

The NPI number for Autumn D Mercer Agnp-C LLC is 1790241065. It was assigned to this organization in the NPPES registry on February 12, 2019.

Where is Autumn D Mercer Agnp-C LLC located?

Autumn D Mercer Agnp-C LLC is located at 620 N 5th St, Jacksonville, OR 97530. The listed phone number is (503) 309-8026.

What is Autumn D Mercer Agnp-C LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Autumn D Mercer Agnp-C LLC enrolled in Medicare?

Yes. Autumn D Mercer Agnp-C LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Autumn D Mercer Agnp-C LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Autumn D Mercer Agnp-C LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Autumn D Mercer Agnp-C LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2299707) is associated with this NPI, valid through February 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Autumn D Mercer Agnp-C LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Autumn D Mercer Agnp-C LLC 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 Autumn D Mercer Agnp-C LLC was last updated on October 24, 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.