JACOB STUART GRANGE (NPI# 1508200833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508200833 |
| Entity Type | Individual |
| Full Name | JACOB STUART GRANGE |
| Credential | M.D. |
| Practice Address |
1032 E Jackson St Medford OR 97504 |
| Mailing Address |
1032 E Jackson St Medford OR 97504-7027 |
| Practice Telephone | 5417704559 |
| Practice Fax Number | 5417704511 |
| Mailing Telephone | 5417704559 |
| Mailing Fax Number | 5417704511 |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2018-06-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
MD186209 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 0116026086 | VA | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1215 Lee St, Box 800904, Charlottesville, VA 229080816 | 4349821018 | 4349249492 |
| Street Address |
1032 E JACKSON ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356346472 | Robin C Pike | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2005-06-15 |
| 1487928420 | Vista Pathology Laboratory, LLC | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2012-03-07 |
| 1356584106 | Michael Daniel Kyle | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2009-04-09 |
| 1235104860 | Gabriella Cardoza-favarato | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356346472 | Robin C Pike | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2005-06-15 |
| 1487928420 | Vista Pathology Laboratory, LLC | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2012-03-07 |
| 1245468172 | Medford Clinical Laboratories | Pathology | 170 Governors Ave, Medford, MA 02155-1643 | 2009-06-30 |
| 1356584106 | Michael Daniel Kyle | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2009-04-09 |
| 1720209109 | Anne Huang | Pathology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2007-05-01 |
| 1245249515 | Randal R Nixon | Pathology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-08-05 |
| 1578513321 | Vista Pathology PC | Pathology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-05-11 |
| 1235104860 | Gabriella Cardoza-favarato | Pathology | 1032 E Jackson St, Medford, OR 97504-7027 | 2006-02-17 |
| 1750386512 | James Norman Olson | Pathology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2005-06-17 |
| 1730184417 | Michael Thane Reedy | Pathology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2005-06-17 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.