Individual provider Active NPI

Carla Remeschatis, CHW

  • Community Health Worker
  • Portland, OR
National Provider Identifier
1275112237
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
THW000004025 Issued in OR
Practice address
3653 SE 34TH Ave
Portland, OR 97202-3034
Phone
(503) 988-6628
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X THW4025 OR
Community Health Worker 172V00000X THW000004025 OR Primary

Addresses

Primary practice location

3653 SE 34TH Ave
Portland, OR 97202-3034

Mailing address

3653 SE 34TH Ave
Portland, OR 97202-3034
Phone (503) 988-6628

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
THW000004025ORMDCommunity Health Worker
THW4025ORMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1275112237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3653 SE 34TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023034",
            "telephone_number": "503-988-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3653 SE 34TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023034",
            "telephone_number": "503-988-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMESCHATIS",
        "first_name": "CARLA",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "THW4025",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "THW000004025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.