Individual provider Active NPI

Christine Marcou Eighmey, PNP

  • Pediatric Nurse Practitioner
  • Portland, OR
National Provider Identifier
1265633234
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
201150135NP Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Mail Code CDW 7
Portland, OR 97239-3011
Phone
(503) 494-7764
Fax
(503) 494-6467
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 201150135NP OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Mail Code CDW 7
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Mail Code CDW 7
Portland, OR 97239-3011
Phone (503) 494-7764

Other identifiers 1

IdentifierTypeStateIssuer
201150135NPOtherORLICENSE

Other names 1

  • Gwenith Christine Marcou Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130514000650 OR Practitioner - Nurse Practitioner 1850538687 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201150135NPORMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Apr 1, 2013 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
University Professional Services CurrentSince Apr 1, 2013 Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 11, 2023 Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 11, 2023 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3101 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 221-3424

3181 SW Sam Jackson Park Rd
#7
Portland, OR 97239
Phone (503) 494-7764

Interoperability endpoints

  • Direct secure messaging: ceighmeynp80362@direct.ohsu.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1265633234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE CDW 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7764",
            "fax_number": "503-494-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE CDW 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7764",
            "fax_number": "503-494-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIGHMEY",
        "first_name": "CHRISTINE",
        "middle_name": "MARCOU",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "201150135NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "201150135NP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENITH",
            "last_name": "MARCOU",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.