Individual provider Active NPI

Rebecca Jane Herreman Scrafford, PSYD

  • Clinical Psychologist
  • Bend, OR
National Provider Identifier
1093843427
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1930 Issued in OR
Practice address
2600 NE Neff Rd
Bend, OR 97701-6337
Phone
(541) 706-6843
Fax
(541) 598-3444
NPI assigned
Feb 28, 2007
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1930 OR Primary

Addresses

Primary practice location

2600 NE Neff Rd
Bend, OR 97701-6337

Mailing address

2542 NE Courtney Dr
Bend, OR 97701-7685
Phone (541) 706-7730

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rscrafford18155@secure.stcharleshealthcare.org

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110511000670 OR Practitioner - Clinical Psychologist 3476739251 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1930ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Apr 1, 2011 Accepting new patients
St. Charles Health System, Inc. CurrentSince Apr 1, 2011 Accepting new patients
St. Charles Health System, Inc. Current Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2036 NE Williamson Ct
Bend, OR 97701
Phone (541) 318-4249

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

2542 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-2768

2600 NE Neff Rd
Bend, OR 97701
Phone (541) 706-3700

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1093843427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017685",
            "telephone_number": "541-706-7730",
            "fax_number": "541-706-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016337",
            "telephone_number": "541-706-6843",
            "fax_number": "541-598-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRAFFORD",
        "first_name": "REBECCA",
        "middle_name": "JANE HERREMAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rscrafford18155@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2600 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.