Sally Jo Niedermeyer, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

080045857RN Issued in OR

Practice address

5211 NE Glisan St BLDG C
Portland, OR 97213-3052

Phone

(503) 215-3081

NPI assigned

Oct 6, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1023568649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 404",
            "city": "GOVERNMENT CAMP",
            "state": "OR",
            "postal_code": "970280404",
            "telephone_number": "503-505-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 NE GLISAN ST BLDG C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133052",
            "telephone_number": "503-215-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERMEYER",
        "first_name": "SALLY",
        "middle_name": "JO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "080045857RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Anne Joseph Nidiry, MD
• Dolores A Niebergall, PT
• Kimberly Catherine Nieblas, AUD
• Edouard Niedenthal Duret
• Jayne Niederkorn
• Hunter Douglas Niehus, MD
• Karlyn Nieland
• Angela Nielsen
• Benjamin Adam Nielsen, DMD
• Heather Nielsen

• Community Health Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Community Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.