Individual provider Active NPI

Zackery David Nance, DPM

  • Podiatrist
  • Portland, OR
National Provider Identifier
1194012989
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP167551 Issued in OR
Practice address
5050 NE Hoyt St Ste 223
Portland, OR 97213-2980
Phone
(503) 963-2964
Fax
(503) 963-2966
NPI assigned
Jun 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006300 PA
Podiatrist 213E00000X DP167551 OR Primary

Addresses

Primary practice location

5050 NE Hoyt St Ste 223
Portland, OR 97213-2980

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

4212 NE Broadway Ste 101
Portland, OR 97213-1422
Phone (503) 963-2964

Other identifiers 2

IdentifierTypeStateIssuer
1194012989MedicaidWA
500670855MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_podiatry_plaza_front_desk_pool12223249@oc.providencedirect.org The Oregon Clinic PC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140521000504 OR Practitioner - Podiatry 3476776410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

1111 NE 99TH Ave
Portland, OR 97220-9442

4212 NE Broadway
Portland, OR 97213-1422
Phone (503) 249-8787

4805 NE Glisan
Portland, OR 97213-2933

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

5050 NE Hoyt St
Suite 223
Portland, OR 97213-2980
Phone (503) 963-2964

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue99
Removal of nail tissue346
Removal or shaving of skin growth169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006300PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic PC CurrentSince Jul 1, 2014 Accepting new patients
The Oregon Clinic, PC CurrentSince Jul 1, 2014 Accepting new patients

Locations

5050 NE Hoyt St
Ste 428
Portland, OR 97213
Phone (503) 231-3355

5050 NE Hoyt St
Ste 223
Portland, OR 97213
Phone (503) 230-3603

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

847 NE 19th Ave
Ste 300
Portland, OR 97232

4212 NE Broadway
Ste 101
Portland, OR 97213
Phone (503) 963-2964

Interoperability endpoints

  • Direct secure messaging: znance447784@oc.providencedirect.org
  • Direct secure messaging: cc_otoc_podiatry_plaza_front_desk_pool12223249@oc.providencedirect.org

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.

Hospital & facility affiliations 4

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1194012989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 223",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132980",
            "telephone_number": "503-963-2964",
            "fax_number": "503-963-2966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4212 NE Broadway Ste 101",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972131422",
            "country_code": "US",
            "telephone_number": "503-963-2964",
            "fax_number": "503-963-2966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NANCE",
        "first_name": "ZACKERY",
        "middle_name": "DAVID",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006300",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP167551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194012989",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670855",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_podiatry_plaza_front_desk_pool12223249@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "5050 NE Hoyt St Ste 223",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.