Active NPI
Jessica Anne Hargadine
- Advanced Practice Midwife
- Gresham, OR
National Provider Identifier
1124851811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 10031483
- Practice address
- 24850 SE Stark St Ste 200
Gresham, OR 97030-8320 - Phone
- (503) 491-9444
- NPI assigned
- Aug 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 10031483 | ||
| Advanced Practice Midwife | 367A00000X | 10031483 | OR | Primary |
Addresses
Primary practice location
24850 SE Stark St Ste 200
Gresham, OR 97030-8320
Mailing address
1416 C St
Washougal, WA 98671-2332
Phone (406) 498-2400
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Clinics LLC | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Legacy Mount Hood Medical Center | Past | Accepting new patients |
Locations
24850 SE Stark St
Ste 200
Gresham, OR 97030
Phone (503) 491-9444
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
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.
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
-
- Rural Health Clinic/Center
- Sandy, OR
- NPI 1730472192
-
- General Acute Care Hospital
- Gresham, OR
- NPI 1255354700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1124851811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1416 C ST",
"city": "WASHOUGAL",
"state": "WA",
"postal_code": "986712332",
"telephone_number": "406-498-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24850 SE STARK ST STE 200",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970308320",
"telephone_number": "503-491-9444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARGADINE",
"first_name": "JESSICA",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-20",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": null,
"license": "10031483",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "OR",
"license": "10031483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.