Individual provider Active NPI

Lauren A Hodgson, PA-C

  • Vascular & Interventional Radiology Physician
  • Salem, OR
National Provider Identifier
1104236371
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
PA175874 Issued in OR
Practice address
2925 Ryan Dr SE
Salem, OR 97301-9687
Phone
(503) 399-1262
NPI assigned
Apr 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA175874 OR
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X PA175874 OR Primary

Addresses

Primary practice location

2925 Ryan Dr SE
Salem, OR 97301-9687

Mailing address

2925 Ryan Dr SE
Salem, OR 97301-9687
Phone (503) 763-7471

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
I20160308001886 OR Practitioner - Physician Assistant 1658677265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salem Radiology Consultants PCGroup PAC ID 0446148498, 33 clinicians

Practice addresses (Care Compare)

2925 Ryan Dr SE
Salem, OR 97301-9687
Phone (503) 399-1262

3043 NE 28TH St
Lincoln City, OR 97367-4518
Phone (541) 994-3661

525 SE Washington St
Dallas, OR 97338-2834
Phone (503) 623-7302

7021 SW Canyon CRST
Portland, OR 97225-3622
Phone (844) 825-9300

800 SW 13TH Ave
Portland, OR 97205-1902
Phone (503) 221-0161

930 SW Abbey St
Newport, OR 97365-4820
Phone (541) 265-2244

Hospital & facility affiliations

  • Salem Hospital Hospital, Salem, OR, CCN 380051
  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Clinic, PC Single Specialty CurrentSince Nov 13, 2019 Accepting new patients
Salem Health Single Specialty Past Accepting new patients
Salem Imaging LLC Single Specialty Past Accepting new patients

Locations

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

2925 Ryan Dr SE
Salem, OR 97301
Phone (503) 399-1262

Organizations & group practices 4

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 2

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1104236371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-763-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-399-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGSON",
        "first_name": "LAUREN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA175874",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "PA175874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.