Individual provider Active NPI

James Christopher Perdue, CRNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1073391553
Registry record updated Dec 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10015019 Issued in OR
Practice address
2119 NE Halsey St
Portland, OR 97232-1522
Phone
(503) 975-9398
Fax
(503) 221-8320
NPI assigned
Sep 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2025

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 10015019 OR Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1-153747 AL

Addresses

Primary practice location

2119 NE Halsey St
Portland, OR 97232-1522

Mailing address

2119 NE Halsey St
Portland, OR 97232-1522
Phone (503) 975-9398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241205000774 AL Practitioner - Nurse Practitioner 0547796286
I20250218003219 OR Practitioner - Nurse Practitioner 0547796286 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-153747ALMDFamily Nurse Practitioner
10015019ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maxem Health Urgent Care Lake Oswego Single Specialty CurrentSince Jan 1, 2025 Accepting new patients
Bywater Health, LLC Past Accepting new patients

Locations

17437 Boones Ferry Rd
Ste 100
Lake Oswego, OR 97035
Phone (503) 387-3796

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764979200000",
    "number": "1073391553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321522",
            "telephone_number": "503-975-9398",
            "fax_number": "503-221-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321522",
            "telephone_number": "503-975-9398",
            "fax_number": "503-221-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "JAMES",
        "middle_name": "CHRISTOPHER",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-12-06",
        "certification_date": "2025-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10015019",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-153747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.