NPIMap

Organization Active NPI

Providence St Vincent Hospital

  • General Acute Care Hospital
  • Portland, OR
National Provider Identifier
1083866933
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PROVIDENCE ST VINCENT HOSPITAL
Practice address
1235 NE 47TH Ave
Suite 285
Portland, OR 97213-2100
Phone
(503) 215-9553
Fax
(503) 215-0825
NPI assigned
Oct 22, 2008
Organization subpart
Yes
Parent organization
PROVIDENCE HEALTH & SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Authorized official

Name
Mrs. Lisa A Witzel
Title
Insurance Verifier
Phone
(503) 215-9553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1235 NE 47TH Ave
Suite 285
Portland, OR 97213-2100

Mailing address

1235 NE 47TH Ave
Suite 285
Portland, OR 97213-2100
Phone (503) 215-9553

Other identifiers 1

IdentifierTypeStateIssuer
193805MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
St Vincent HSP and Med9 organizations share this tax ID, including this one
Part of
St Vincent HSP and Med

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1235 NE 47th Ave
Ste 285
Portland, OR 97213
Phone (503) 215-9553

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1083866933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 NE 47TH AVE",
            "address_2": "SUITE 285",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132100",
            "telephone_number": "503-215-9553",
            "fax_number": "503-215-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 NE 47TH AVE",
            "address_2": "SUITE 285",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132100",
            "telephone_number": "503-215-9553",
            "fax_number": "503-215-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ST VINCENT HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "WITZEL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "INSURANCE VERIFIER",
        "authorized_official_telephone_number": "503-215-9553",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193805",
            "state": "OR"
        }
    ],
    "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 Oct 22, 2008; 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.