Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heather Larena Bascom, FNP

Individual provider Registered Nurse · NPI 1124660154

Heather Larena Bascom, FNP is a Nurse Practitioner in Medford, Oregon. Qualified in 2020, 6 years ago. Practices with Northeastern Utah Medical Group, a 51-clinician group and accepts Medicare assignment. Licensed in Oregon and Utah.

Years since qualifying
6
Licensed in
OR, UT
In the registry since
2019
Specialties on file
3
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

2825 E Barnett Rd
Medford, OR 97504-8332
Phone: (541) 789-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10021529 (OR)
Registered Nurse Taxonomy 163W00000X · Licence 362422-3102 (UT)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 362422-4405 (UT)

Record details

NPI number1124660154
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedOctober 10, 2019
Last updated in NPPESJuly 18, 2024
Certification dateJuly 18, 2024
Mailing address2825 E Barnett Rd, Medford, OR 97504-8332

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northeastern Utah Medical Group — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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