Individual provider Active NPI

Berney Smith Zepeda

  • Home Modifications Contractor
  • Salem, OR
National Provider Identifier
1003503426
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
235236 Issued in OR
Practice address
1045 Teviot PL NW
Salem, OR 97304-3111
Phone
(503) 779-5090
NPI assigned
Apr 18, 2023
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1104513092MedicaidOR

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

LicenseStateTypeSpecialty
235236ORMDHome Modifications Contractor

Practice roles

OrganizationSpecialtyStatusNew patients
Procision Ramps LLC Home Modifications CurrentSince Apr 23, 2023 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.

Verify at the official NPI Registry.