Individual provider Active NPI

June Ellen Hobbs, CNM

  • Advanced Practice Midwife
  • Gresham, OR
National Provider Identifier
1063558807
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
200650131NP Issued in OR
Practice address
24850 SE Stark St
Suite 200
Gresham, OR 97030-8316
Phone
(503) 491-9444
Fax
(503) 661-3430
NPI assigned
Jan 29, 2007
Last updated
Jan 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 200650131NP OR Primary

Addresses

Primary practice location

24850 SE Stark St
Suite 200
Gresham, OR 97030-8316

Mailing address

24850 SE Stark St
Suite 200
Gresham, OR 97030-8316
Phone (503) 491-9444

Other identifiers 1

IdentifierTypeStateIssuer
200650131NPOtherORSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Feb 10, 2020 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 10, 2020 Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

24850 SE Stark St
Ste 200
Gresham, OR 97030
Phone (503) 491-9444

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1063558807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24850 SE STARK ST",
            "address_2": "SUITE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308316",
            "telephone_number": "503-491-9444",
            "fax_number": "503-661-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24850 SE STARK ST",
            "address_2": "SUITE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308316",
            "telephone_number": "503-491-9444",
            "fax_number": "503-661-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBBS",
        "first_name": "JUNE",
        "middle_name": "ELLEN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "200650131NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "200650131NP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.