NPIMap

Organization Active NPI

Northwest IV, LLC

Doing business as Evolve Health

  • Family Nurse Practitioner
  • Bend, OR
National Provider Identifier
1225619703
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NORTHWEST IV, LLC
Doing business as
Evolve Health
Practice address
2255 NW Shevlin Park Rd Ste 110
Bend, OR 97703-7134
Phone
(541) 728-2525
Fax
(971) 223-0919
NPI assigned
Apr 16, 2021
Organization subpart
Yes
Parent organization
NORTHWEST IV, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Authorized official

Name
John Perry
Title
Managing Director
Phone
(971) 358-9292

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2255 NW Shevlin Park Rd Ste 110
Bend, OR 97703-7134

Mailing address

6400 SE Lake Rd Ste 155
Portland, OR 97222-2137
Phone (503) 447-3285

Other names 1

  • Evolve Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190327002802 OR Part B Supplier - Clinic/Group Practice 7214277383 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beaverton, OR; Bend, OR; Portland, OR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Northwest IV LLC4 organizations share this tax ID, including this one
Part of
Northwest IV LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2235 NW Shevlin Park Rd
Ste 110
Bend, OR 97703

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1225619703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SE LAKE RD STE 155",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972222137",
            "telephone_number": "503-447-3285",
            "fax_number": "503-917-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 NW SHEVLIN PARK RD STE 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037134",
            "telephone_number": "541-728-2525",
            "fax_number": "971-223-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST IV, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST IV, LLC",
        "enumeration_date": "2021-04-16",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "971-358-9292"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolve Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.