Laura Dillard, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201705362NP-PP Issued in OR

Practice address

10822 SE 82ND Ave
Happy Valley, OR 97086

Phone

(503) 239-8400

NPI assigned

Jan 11, 2014

Last updated

Jun 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Laura Iwata Former name

Medicare fee-for-service enrollment

Enrolled in OR, WA, CO3 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 3

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Emanuel Hospital and Health CenterGroup PAC ID 4587573639, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment Care Compare group NPD
• Active Recovery TMS PLLC

  dba Active Path Mental Health

  • Psychiatry Physician
  • Clackamas, OR
  • NPI 1881287787

  WA

  Medicare reassignment NPD
• Boulder Care Provider Group PA

  dba Boulder Care

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  CO, WA

  Medicare reassignment
• Coda, Inc.

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1437213865
  NPD
• Coda, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaside, OR
  • NPI 1750912184
  NPD
• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027
  NPD

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

• Legacy Emanuel Hospital & Health Center

  dba Unity Center for Behavioral Health-PES

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491
  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  dba Legacy Laboratory Services

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Care Compare affiliation

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1083036990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-296-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10822 SE 82ND AVE",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "97086",
            "telephone_number": "503-239-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 SE International Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "97222",
            "country_code": "US",
            "telephone_number": "971-206-5173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10362 SW McDonald St",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972244863",
            "country_code": "US",
            "telephone_number": "503-239-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 SW Washington Street",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "97123",
            "country_code": "US",
            "telephone_number": "503-239-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "LAURA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-11",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201142492RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201705362NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201705362NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "IWATA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.