FRED GARNICA (NPI# 1578933123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578933123 |
| Entity Type | Individual |
| Full Name | FRED GARNICA |
| Practice Address |
503 Airport Rd Ste 101 Medford OR 97504-4159 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5412002900 |
| Practice Fax Number | 5412002948 |
| Mailing Telephone | 5418588170 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2020-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA186717 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
503 AIRPORT RD STE 101 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-4159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902003080 | Sunny Kim | Psychiatry & Neurology | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2007-07-02 |
| 1003417973 | Leslie Michelle Williams | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2020-11-05 |
| 1871107573 | Marcy Jo Hansen | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2020-09-01 |
| 1225651938 | Sadie Teagan Trautwein | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2020-05-28 |
| 1407477763 | Melinda Michelle Cain | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2020-04-28 |
| 1629604103 | Angelica Jean Flowers | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2020-03-17 |
| 1639715964 | Jennifer Andrews | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2019-11-21 |
| 1508400318 | Rachel Hill Stewart | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2019-11-05 |
| 1346884350 | Kyndra Marie Connor | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2019-11-01 |
| 1891348025 | Brian M Locke | Counselor | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2019-07-17 |
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| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932346095 | Elena Tovkan Forster | Physician Assistant | 2924 Siskiyou Blvd Ste 200, Medford, OR 97504 | 2009-01-12 |
| 1245416544 | Alanna R Dixon | Physician Assistant | 1698 E. Mcandrews Rd, Suite 400, Medford, OR 97504-5590 | 2008-01-16 |
| 1134784580 | Amanda Nicole Taylor | Physician Assistant | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2019-05-01 |
| 1295398766 | Lindsey R Robinson | Physician Assistant | 19 Myrtle St, Medford, OR 97504-7337 | 2019-04-19 |
| 1396226247 | Mason Scott Hoying | Physician Assistant | 1698 E Mcandrews Rd Ste 400, Medford, OR 97504-5590 | 2018-08-28 |
| 1720598287 | Ryan Mcdaniel | Physician Assistant | 2780 E Barnett Rd, Medford, OR 97504-8674 | 2017-10-10 |
| 1861946931 | Erica Florence Smith | Physician Assistant | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2016-08-06 |
| 1003297581 | Gregory Lee Werner | Physician Assistant | 143 S Gibson St, Medford, WI 54451-1622 | 2015-06-10 |
| 1780087502 | Dillon Smith | Physician Assistant | 2780 E Barnett Rd Ste 200, Medford, OR 97504 | 2014-10-07 |
| 1861802944 | Landon Masterfield | Physician Assistant | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2014-04-29 |
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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.