Alyssa Marie O'Brien, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-D-10184454 Issued in OR

Practice address

1111 NE 99TH Ave
Portland, OR 97220-9428

Phone

(503) 963-2707

Fax

(503) 963-2802

NPI assigned

Dec 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gi Nutrition NW, LLCGroup PAC ID 7911395348, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gi Nutrition NW, LLC

  • Registered Dietitian
  • Portland, OR
  • NPI 1427632884

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023483799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322686",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NE 99TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209428",
            "telephone_number": "503-963-2707",
            "fax_number": "503-963-2802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1508 Division St Ste 15",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451583",
            "country_code": "US",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9701 SW Barnes Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256689",
            "country_code": "US",
            "telephone_number": "503-297-8081",
            "fax_number": "503-292-6601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19250 SW 90th Ave",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627585",
            "country_code": "US",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "984417",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10184454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086834",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500732181",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myong Penny O, CSWA
• Katy O'Bannon
• Katherine Eileen O'Bar, RD
• Megan O'Bara
• Kit B O'Boyle, RN, BSN, MSW, LCSW
• Ashley O'Brien, QMHA
• Brendan O'Brien, DO
• Darcy Grace O'Brien
• David Patrick O'Brien IV, MD
• Eric O'Brien, OT-C

• Registered Dietitian in Portland, OR
• Providers in Portland, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.