Individual provider Active NPI

Theresa McSherry, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1093169583
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201701536NP-PP Issued in OR
Practice address
501 N Graham St Ste 555
Portland, OR 97227-2007
Phone
(503) 288-7535
Fax
(503) 288-7538
NPI assigned
Apr 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201701536NP-PP OR Primary

Addresses

Primary practice location

501 N Graham St Ste 555
Portland, OR 97227-2007

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
2076130MedicaidWA
500722007MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referringsbs@1243.direct.myezyaccess.com The Oregon Clinic PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170324001588 OR Practitioner - Nurse Practitioner 7911282439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

501 N Graham St
Suite 555
Portland, OR 97227-2007
Phone (503) 288-7535

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201701536NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic PC CurrentSince Mar 9, 2017 Accepting new patients
The Oregon Clinic, PC CurrentSince Mar 9, 2017 Accepting new patients
Vibra Physicians LLC CurrentSince May 25, 2019 Accepting new patients

Locations

847 NE 19th Ave
Ste 300
Portland, OR 97232

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

10300 NE Hancock St
Portland, OR 97220
Phone (503) 257-5500

501 N Graham St
Ste 555
Portland, OR 97227
Phone (503) 288-7535

8081 Royal Ridge Pkwy
Ste 130
Irving, TX 75063
Phone (844) 870-6689

Interoperability endpoints

  • Direct secure messaging: tmcsherry3166825@oc.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1093169583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 555",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272007",
            "telephone_number": "503-288-7535",
            "fax_number": "503-288-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSHERRY",
        "first_name": "THERESA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201701536NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2076130",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500722007",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringsbs@1243.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "501 N Graham St Ste 555",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972272007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.