Active NPI
Judy Vickery
- Community Health Registered Nurse
- Beaverton, OR
National Provider Identifier
1063103158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- 200941059RN
- Practice address
- 20545 SW Parker CT
Beaverton, OR 97078-1030 - Phone
- (503) 719-9515
- NPI assigned
- May 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 200941059RN | OR | Primary |
Addresses
Primary practice location
20545 SW Parker CT
Beaverton, OR 97078-1030
Mailing address
20545 SW Parker CT
Beaverton, OR 97078-1030
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
| License | State | Type | Specialty |
|---|---|---|---|
| 200941059RN | OR | MD | Community Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1063103158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20545 SW PARKER CT",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970781030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20545 SW PARKER CT",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970781030",
"telephone_number": "503-719-9515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKERY",
"first_name": "JUDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2023-05-18",
"certification_date": "2023-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "OR",
"license": "200941059RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.