Active NPI
Jo Ellen Schoblom, BSN,MS, WHCNP
- Women's Health Nurse Practitioner
- Beaverton, OR
National Provider Identifier
1255464772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 075034762N7
- Practice address
- 4855 SW Western Ave
Beaverton, OR 97005-3460 - Phone
- (503) 520-4893
- NPI assigned
- Mar 13, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 075034762N7 | OR | Primary |
Addresses
Primary practice location
4855 SW Western Ave
Beaverton, OR 97005-3460
Mailing address
7546 SW Aloma Way
# 6
Portland, OR 97223-7929
Phone (503) 452-8762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor on Science - Nursing, Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075034762N7 | OR | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255464772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7546 SW ALOMA WAY",
"address_2": "# 6",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972237929",
"telephone_number": "503-452-8762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053460",
"telephone_number": "503-520-4893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHOBLOM",
"first_name": "JO",
"middle_name": "ELLEN",
"credential": "BSN,MS, WHCNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "OR",
"license": "075034762N7",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.