| One Family Medical Group, LLC | |
|
1619 Nw Hawthorne Ave Ste 203 Grants Pass OR 97526-6009 | |
| (541) 474-5511 | |
| Not Available |
| Full Name | One Family Medical Group, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1619 Nw Hawthorne Ave Ste 203, Grants Pass, Oregon |
| Authorized Official Name and Position | Tori Rumrey (PROVIDER) |
| Authorized Official Contact | 5414745511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| One Family Medical Group, LLC 1619 Nw Hawthorne Ave Ste 203 Grants Pass OR 97526-6009 Ph: (541) 474-5511 | One Family Medical Group, LLC 1619 Nw Hawthorne Ave Ste 203 Grants Pass OR 97526-6009 Ph: (541) 474-5511 |
| NPI Number | 1306207006 |
|---|---|
| Provider Enumeration Date | 03/09/2016 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Medicare PECOS PAC ID | 2365732880 |
|---|---|
| Medicare Enrollment ID | O20160610001691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306207006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 201601213NP-PP (Oregon) | Primary |
| Provider Name | Tori Lynn Rumrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447619192 PECOS PAC ID: 3274823794 Enrollment ID: I20160610001798 |
| Provider Name | Sheldon Junior Mckenzie |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1164772281 PECOS PAC ID: 5395030316 Enrollment ID: I20160829003358 |
| Provider Name | Doreen Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083257109 PECOS PAC ID: 4284068982 Enrollment ID: I20200206000863 |
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