Active NPI
Valerie Lederer, APRN
- Nurse Practitioner
- Portland, OR
National Provider Identifier
1275938896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 201707472NP-PP
- Practice address
- 3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964 - Phone
- (503) 660-0600
- NPI assigned
- Oct 24, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP9328814 | FL | |
| Nurse Practitioner | 363L00000X | AP60781553 | WA | |
| Nurse Practitioner | 363L00000X | 201707472NP-PP | OR | Primary |
Addresses
Primary practice location
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Mailing address
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Other practice location 1
2600 Highway 301 S
Jesup, GA 31599-5676
Phone (912) 427-0870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180108003030 | WA | Order and Referring Only - Nurse Practitioner | 9830458348 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9328814 | FL | MD | Nurse Practitioner |
| 201707472NP-PP | OR | MD | Nurse Practitioner |
| AP60781553 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fci Jesup | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Prison Health Clinic/Center
- Jesup, GA
- NPI 1508538679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1275938896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392964",
"telephone_number": "503-660-0600"
}
],
"practiceLocations": [
{
"address_1": "2600 Highway 301 S",
"address_purpose": "LOCATION",
"city": "Jesup",
"state": "GA",
"postal_code": "315995676",
"country_code": "US",
"telephone_number": "912-427-0870",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEDERER",
"first_name": "VALERIE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-24",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP9328814",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP60781553",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OR",
"license": "201707472NP-PP",
"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 Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.