Individual provider Active NPI

Whitney Thomas

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1043967151
Registry record updated Mar 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202113520NP-PP Issued in OR
Practice address
12710 SE Division St
Portland, OR 97236-3134
Phone
(503) 988-5558
NPI assigned
Mar 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61241993 WA
Family Nurse Practitioner 363LF0000X 202113520NP-PP OR Primary

Addresses

Primary practice location

12710 SE Division St
Portland, OR 97236-3134

Mailing address

12710 SE Division St
Portland, OR 97236-3134
Phone (503) 988-5558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222002155 OR Practitioner - Nurse Practitioner 6305216912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

12710 SE Division
Mid County Health Center
Portland, OR 97236-3134
Phone (503) 988-3601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61241993WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County Current Accepting new patients
Multnomah County CurrentSince Oct 18, 2022 Accepting new patients
Multnomah County CurrentSince Oct 18, 2022 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

619 NW 6th Ave
Portland, OR 97209
Phone (503) 988-3674

12710 SE Division St
Portland, OR 97236
Phone (503) 988-3410

Interoperability endpoints

  • Direct secure messaging: wthomas602057@direct.ochin.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710547200000",
    "number": "1043967151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12710 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363134",
            "telephone_number": "503-988-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363134",
            "telephone_number": "503-988-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "WHITNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61241993",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202113520NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.