NPIMap

Individual provider Active NPI

Myra Hart

  • Community Health Worker
  • Salem, OR
National Provider Identifier
1285024174
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
7624358 Issued in OR
Practice address
4890 32ND Ave SE
Salem, OR 97317-9350
Phone
(503) 588-5647
Fax
(503) 588-0509
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 7624358 OR Primary

Addresses

Primary practice location

4890 32ND Ave SE
Salem, OR 97317-9350

Mailing address

1144 McGee CT NE
Apt 204
Keizer, OR 97303-9470
Phone (503) 983-4898

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
7624358ORMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Community Placement Center Past Accepting new patients
Christian Community Placement Center Past Accepting new patients

Organizations & group practices 2

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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1285024174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 MCGEE CT NE",
            "address_2": "APT 204",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973039470",
            "telephone_number": "503-983-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4890 32ND AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973179350",
            "telephone_number": "503-588-5647",
            "fax_number": "503-588-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "MYRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "7624358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.