Individual provider Active NPI

Becky Eve Campana, CRM

  • Community Health Worker
  • Portland, OR
National Provider Identifier
1033645916
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
THW1733 Issued in OR
Practice address
847 NE 19TH Ave
Portland, OR 97232-2684
Phone
(503) 238-0769
NPI assigned
May 11, 2017
Last updated
May 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 17-CRM-012 OR
Community Health Worker 172V00000X THW1733 OR Primary

Addresses

Primary practice location

847 NE 19TH Ave
Portland, OR 97232-2684

Mailing address

PO Box 8459
Portland, OR 97207-8459
Phone (503) 238-0769

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
17-CRM-012ORMDCommunity Health Worker
THW1733ORMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1033645916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-238-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANA",
        "first_name": "BECKY",
        "middle_name": "EVE",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "17-CRM-012",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "THW1733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.