Southern Oregon Medical Clinic - Medicare Primary Care in Medford, OR

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Southern Oregon Medical Clinic is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Medford, Oregon. The current practice location for Southern Oregon Medical Clinic is 2921 Doctors Park Dr Ste B, Medford, Oregon. For appointments, you can reach them via phone at (541) 200-2263. The mailing address for Southern Oregon Medical Clinic is 1744 E Mcandrews Rd, Suite D, Medford, Oregon and phone number is (541) 973-2551.

Southern Oregon Medical Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1538446315. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (541) 200-2263.

Contact Information

Southern Oregon Medical Clinic
2921 Doctors Park Dr Ste B
Medford
OR 97504-8127
(541) 200-2263
(541) 973-2835

Map and Direction


Primary Care Clinic Profile

Full NameSouthern Oregon Medical Clinic
SpecialityClinic/Center
Location2921 Doctors Park Dr Ste B, Medford, Oregon
Authorized Official Name and PositionEric Reed (OWNER)
Authorized Official Contact5412002242
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Southern Oregon Medical Clinic
1744 E Mcandrews Rd
Suite D
Medford
OR 97504

Ph: (541) 973-2551		Southern Oregon Medical Clinic
2921 Doctors Park Dr Ste B
Medford
OR 97504-8127

Ph: (541) 200-2263

NPI Details:

NPI Number1538446315
Provider Enumeration Date11/08/2011
Last Update Date08/26/2021

Medicare PECOS Information:

Medicare PECOS PAC ID5395903124
Medicare Enrollment IDO20120223000945

Medical Identifiers

Medical identifiers for Southern Oregon Medical Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538446315NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QP2300XClinic/center - Primary Care (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Southern Oregon Medical Clinic acts as a billing entity for following providers:
Provider NameJason D Jex
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194089490
PECOS PAC ID: 9436359973
Enrollment ID: I20121116000280
Provider NameBronwen Kaye Erickson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154686020
PECOS PAC ID: 8628229267
Enrollment ID: I20140324000805
Provider NameKacy Lynn Mullen
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1801224795
PECOS PAC ID: 1355567660
Enrollment ID: I20140723000295
Provider NameDannielle Sharon Byers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881005320
PECOS PAC ID: 5890913008
Enrollment ID: I20140902000398
Provider NameNeil R Nicholson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1720356298
PECOS PAC ID: 6406162882
Enrollment ID: I20150831001846
Provider NameAshley N Warner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730547142
PECOS PAC ID: 1658676242
Enrollment ID: I20160218002278
Provider NameAmber Jean Ray Watts
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902223035
PECOS PAC ID: 0446473698
Enrollment ID: I20180222002397
Provider NameLeslie Catherine Tietjen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164071858
PECOS PAC ID: 7214269125
Enrollment ID: I20210205000647
Provider NameSvetlana Melikovna Vitus
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154912632
PECOS PAC ID: 0244645760
Enrollment ID: I20210216001141
Provider NameBronson N. Dull
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1184085151
PECOS PAC ID: 0941616445
Enrollment ID: I20210308002578
Provider NameChristopher Malcolm Patton
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1366402778
PECOS PAC ID: 3678942000
Enrollment ID: I20221207001204
Provider NameJeffrey Patrick Fry
Provider TypePractitioner - Other (physician)
Provider IdentifiersNPI Number: 1144428855
PECOS PAC ID: 8921479338
Enrollment ID: I20230123002000
Provider NameDebra V Davis
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1013787704
PECOS PAC ID: 3870931645
Enrollment ID: I20240329002305

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.