Active NPI
Kimberly A Smith-Cupani, MD
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1013933159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD17933
- Practice address
- 1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9436 - Phone
- (503) 215-4250
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD17933 | OR | Primary |
Addresses
Primary practice location
1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9436
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 044748 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ksmithcupani117702@oc.providencedirect.org |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601596800000",
"number": "1013933159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 NE 99TH AVE",
"address_2": "SUITE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972209436",
"telephone_number": "503-215-4250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH-CUPANI",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2020-10-02",
"certification_date": "2020-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD17933",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "044748",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ksmithcupani117702@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1321 NE 99th Ave",
"address_2": "Suite 200",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972209436",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Portland, OR
- Martin Jay Smilkstein, M.D.
- Michael Forrest Smira
- Taylor Russell Smith-Bedsworth, LMT
- Jessica Smith-Blockley, P.T
- Erica L Smith-Cohen, AGACNP
- Melissa Marie Smith-Hohnstein, LCSW, MSW
- Zane Allen Smith-Lundy, RN
- Lilyan Charlotte Russel Smith-Moore, M.ED.
- Kerri Smith-Slingerland, MSW, LCSW, CADC I, C
- Lynn A Smith-Stott, CDP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.