Individual provider Active NPI

Tomie Jean Nelson

  • Community Health Worker
  • Portland, OR
National Provider Identifier
1083574628
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
5005 SE 72ND Ave Apt 408
Portland, OR 97206-4476
Phone
(503) 446-7078
NPI assigned
Nov 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X OR Primary

Addresses

Primary practice location

5005 SE 72ND Ave Apt 408
Portland, OR 97206-4476

Mailing address

5005 SE 72ND Ave Apt 408
Portland, OR 97206-4476
Phone (503) 446-7078

Other practice location 1

1027 E Burnside St
Portland, OR 97214-1328
Phone (503) 239-8400

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coda, Inc. PastSince Feb 9, 2020 Accepting new patients
Coda, Inc. PastSince Aug 13, 2019 Accepting new patients

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": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1083574628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 SE 72ND AVE APT 408",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064476",
            "telephone_number": "503-446-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 SE 72ND AVE APT 408",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064476",
            "telephone_number": "503-446-7078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1027 E Burnside St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972141328",
            "country_code": "US",
            "telephone_number": "503-239-8400",
            "fax_number": "503-206-7164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TOMIE",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.