Active NPI
Berney Smith Zepeda
- Home Modifications Contractor
- Salem, OR
National Provider Identifier
1003503426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 235236
- Practice address
- 1045 Teviot PL NW
Salem, OR 97304-3111 - Phone
- (503) 779-5090
- NPI assigned
- Apr 18, 2023
- Last updated
- Apr 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 235236 | OR | Primary |
Addresses
Primary practice location
1045 Teviot PL NW
Salem, OR 97304-3111
Mailing address
1045 Teviot PL NW
Salem, OR 97304-3111
Phone (503) 779-5090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104513092 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 235236 | OR | MD | Home Modifications Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Procision Ramps LLC | Home Modifications | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1003503426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 TEVIOT PL NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973043111",
"telephone_number": "503-779-5090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 TEVIOT PL NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973043111",
"telephone_number": "503-779-5090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEPEDA",
"first_name": "BERNEY",
"middle_name": "SMITH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "OR",
"license": "235236",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104513092",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.