Individual provider Active NPI

Miriam Champer

  • Obstetrics & Gynecology Physician
  • Bend, OR
National Provider Identifier
1114458064
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD204123 Issued in OR
Practice address
2400 NE Neff Rd Ste a
Bend, OR 97701-6752
Phone
(541) 389-3300
Fax
(541) 389-8115
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD204123 OR Primary

Addresses

Primary practice location

2400 NE Neff Rd Ste a
Bend, OR 97701-6752

Mailing address

2400 NE Neff Rd Ste a
Bend, OR 97701-6752
Phone (541) 389-3300

Other identifiers 1

IdentifierTypeStateIssuer
500793003MedicaidOR

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707002752 OR Practitioner - Obstetrics/Gynecology 2365780046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Columbia University College of Physicians and Surgeons, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Cascade Womens Group P CGroup PAC ID 9638166796, 18 clinicians

Practice addresses (Care Compare)

2400 NE Neff Rd
Suite a
Bend, OR 97701-6752
Phone (541) 389-3300

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
East Cascade Womens Group, P C Obstetrics & Gynecology CurrentSince Aug 16, 2021 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. PastSince Jun 27, 2021 Accepting new patients

Locations

2400 NE Neff Rd
Ste A
Bend, OR 97701
Phone (541) 389-3300

Interoperability endpoints

  • Direct secure messaging: mchamper24465@coipa.gardenplot.direct-ci.com
  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/ECWG/api/FHIR/R4

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 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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1114458064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NE NEFF RD STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016752",
            "telephone_number": "541-389-3300",
            "fax_number": "541-389-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NE NEFF RD STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016752",
            "telephone_number": "541-389-3300",
            "fax_number": "541-389-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPER",
        "first_name": "MIRIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD204123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500793003",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.