Elizabeth Apollo-Loomis, APNP
Individual provider Active NPI Gerontology Nurse Practitioner · Stayton, OR
NPI 1083147334 · NPPES record last updated Feb 13, 2023
Key facts
- NPI
- 1083147334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 201709153NP-PP (OR)
- Practice address
- 1401 N 10TH Ave
Stayton, OR 97383-1311 - Phone
- (503) 769-9307
- NPI assigned
- Apr 4, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Northwest
Practice addresses (Care Compare)
5940 Ulali Dr NE
Keizer, OR 97303-1500
Phone (800) 813-2000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190822002130 | OR | Practitioner - Nurse Practitioner | 2062774417 | Reassigns benefits to 2 organizations |
| I20240328001361 | WA | Practitioner - Nurse Practitioner | 2062774417 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7618-33 | WI | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Healogics Specialty Physicians of Oregon, LLC | Current |
Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
5940 Ulali Dr NE
Keizer, OR 97303
Phone (503) 304-5738
375 SE Norton Ln
Ste A
McMinnville, OR 97128
Phone (503) 472-5749
500 NE Multnomah St
Fl 11
Portland, OR 97232
875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1460 G St
Springfield, OR 97477
Phone (541) 431-0665
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Interoperability endpoints
- eapollol@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 7618-33 | WI | |
| Gerontology Nurse Practitioner | 363LG0600X | 201709153NP-PP | OR | Yes |
Addresses
Primary practice location
1401 N 10TH Ave
Stayton, OR 97383-1311
Mailing address
28975 SW Orleans Ave Apt 307
Wilsonville, OR 97070-7357
Other names
- Elizabeth Apollo
Other providers in Stayton, OR
- Tammy Lynette Abell
- Hammaad Alvi
- Elizabeth A Anderson
- Carmen L Anglin
- Gary James Anglin
- Mikael Aragon
- Patrick Richard Arden
- Aaron Baird
- Bethany J Banke
- Lawrence Ray Barnes
All providers in Stayton, OR · Gerontology Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.