Individual provider Active NPI

Richard Fredrick Meyers, RN, FNP-BC

  • Nurse Practitioner
  • Salem, OR
National Provider Identifier
1104082197
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201703016NP-PP Issued in OR
Practice address
670 Hawthorne Ave SE
Suite 160
Salem, OR 97301-6884
Phone
(503) 371-1970
Fax
(503) 371-0192
NPI assigned
Jul 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201703016NP-PP OR
Nurse Practitioner 363L00000X 201703016NP-PP OR Primary

Addresses

Primary practice location

670 Hawthorne Ave SE
Suite 160
Salem, OR 97301-6884

Mailing address

670 Hawthorne Ave SE
Suite 160
Salem, OR 97301-6884
Phone (503) 371-1970

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
I20170731000111 OR Practitioner - Nurse Practitioner 7214208958

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201703016NP-PPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Medical Centers LLC CurrentSince Feb 8, 2020 Accepting new patients
Oregon Medical Centers LLC Nurse Practitioner CurrentSince Feb 8, 2020 Accepting new patients

Locations

17575 SW Tualatin Valley Hwy
Aloha, OR 97003
Phone (503) 642-2845

2515 Liberty St NE
Salem, OR 97301
Phone (503) 390-1552

Interoperability endpoints

  • Direct secure messaging: richard.meyers@210851327442948.direct.elationemr.com

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1104082197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 HAWTHORNE AVE SE",
            "address_2": "SUITE 160",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016884",
            "telephone_number": "503-371-1970",
            "fax_number": "503-371-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 HAWTHORNE AVE SE",
            "address_2": "SUITE 160",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016884",
            "telephone_number": "503-371-1970",
            "fax_number": "503-371-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "RICHARD",
        "middle_name": "FREDRICK",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201703016NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201703016NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.