JEREMY WADE ROSS (NPI# 1720496375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720496375 |
| Entity Type | Individual |
| Full Name | JEREMY WADE ROSS |
| Credential | PA |
| Practice Address |
1698 E Mcandrews Rd Ste 300 Medford OR 97504-5590 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5417327950 |
| Practice Fax Number | 5417327901 |
| Mailing Telephone | 5417327950 |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2015-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA169124 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500674465 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093178006 | Jeremy Daniel Ross | Licensed Practical Nurse | 11582 C St, Joint Base Lewis-mcchord, WA 98433 | 2016-03-29 |
| 1265803589 | Jeremy Ross | Counselor | 58 Beach Rd, Hampton, VA 23664-1834 | 2015-10-13 |
| 1215381546 | Jeremy Aaron Ross | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2016-04-23 |
| 1063886950 | Jeremy Ross | Clinical Exercise Physiologist | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2015-11-16 |
| 1063890697 | Jeremy Michael Ross | Family Medicine | 333 S 38th St Ste A, Muskogee, OK 74401-4937 | 2015-05-14 |
| 1013250455 | Jeremy Aaron Ross | Internal Medicine | 800 W Magnolia Ave, Fort Worth, TX 76104-4611 | 2013-04-04 |
| 1801116371 | Jeremy A. Ross | Orthopaedic Surgery | 11958 W Broad St, Henrico, VA 23233 | 2010-06-08 |
| Street Address |
1698 E MCANDREWS RD STE 300 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-5590 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215978671 | Roger J. Dreiling | Internal Medicine | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2006-06-09 |
| 1073170924 | Claudia Mancilla-villa | Community Health Worker | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2019-05-28 |
| 1063847796 | Vickieann Rosenbusch Poremba | Pharmacist | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2013-09-12 |
| 1003154774 | Beverly Kay Riley | Social Worker | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504 | 2013-01-30 |
| 1245595206 | Subhechchha Shah | Family Medicine | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2012-07-05 |
| 1841563251 | Jarrod James Watson | Nurse Practitioner | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2012-02-15 |
| 1588931372 | Deborah Jean Boles | Nurse Practitioner | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504 | 2011-11-21 |
| 1841586146 | Nathan D Reed | Family Medicine | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504 | 2011-06-24 |
| 1790940088 | Cynthia L Mosser | Nurse Practitioner | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2008-07-25 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548867856 | Megan Elaine Stewart | Physician Assistant | 3773 Pinetop Dr, Medford, OR 97504-9638 | 2020-10-08 |
| 1811506355 | Nicholas Fantony | Physician Assistant | 28 Leyden St, Medford, MA 02155-6674 | 2020-07-30 |
| 1033739164 | Giana Brunetti | Physician Assistant | 2 Liverpool Way, Medford, NJ 08055-4023 | 2020-04-18 |
| 1881238087 | Rosivel Flores | Physician Assistant | 853 Old Medford Ave, Medford, NY 11763-3521 | 2019-10-30 |
| 1942844386 | Aileen Yaeger | Physician Assistant | 30 Syracuse Ave, Medford, NY 11763-3621 | 2019-10-29 |
| 1568949477 | Evan Xanthos | Physician Assistant | 1600 Delta Waters Rd Ste 107, Medford, OR 97504-9114 | 2018-07-24 |
| 1104369099 | Cullen Anthony Mack | Physician Assistant | 235 E Barnett Rd, Suite 106, Medford, OR 97501-7901 | 2016-11-23 |
| 1053863662 | Mark Thomas Kestner | Physician Assistant | 44 Manning St, Medford, MA 02155-4422 | 2016-10-30 |
| 1972058840 | Victoria Rose Acilio | Physician Assistant | 103 Old Marlton Pike Ste 201, Medford, NJ 08055-8772 | 2016-08-22 |
| 1962896944 | Jeremy Klimar | Physician Assistant | 407 Jesse Ct, Medford, NY 11763-2139 | 2015-03-26 |
| 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.